• Childhood Kidney Diseases
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• v.13 no.2
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• pp.176-188
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• 2009

Purpose : Peritoneal dialysis (PD) is the major form of dialysis in use for infants and children with end-stage renal disease (ESRD). The aim of this study was to gain insight into the current status of children on PD in Korea. Methods : In May 2008, questionnaires were sent to the pediatric nephrologists via e-mail. Four centers replied and those data were reviewed. Results : A total of 103 patients were included in this study. Male to female ratio was 1.6:1. Mean age was $11.5{\pm}4.9$ years (0-19 years). Primary renal diseases diagnosed were as follows: primary glomerular disease (34%), chronic pyelonephritis-reflux nephropathy (14.6%), systemic disease (9.7%), renal hypoplasia/dysplasia (8.7%), heredofamilial disease (6.8%), vascular disease (3.9%), drug-induced nephropathy (1.0%), and unknown (12.6%). PD modalities were as follows: CAPD (42.7%), CCPD (27.2%), NIPD (11.7%), and Hybrid (18.4%). Weekly total Kt/V was $2.1{\pm}0.7$ (0.3-4.1). Results of peritoneal equilibrium test were as follows: low 36.8%, low average 31.6%, high average 19.7%, and high 11.8%. Z-score for weight was $-1.00{\pm}1.20$ (-4.54~+2.50). Z-score for height was $-1.55{\pm}1.65$ (-9.42~+1.87). Growth hormone was administered in 24.3% of patients. Anti-hypertensive drugs were administered in 64.0% of patients. Laboratory findings were as follows: hemoglobin $10.5{\pm}1.4$ g/dL, calcium $9.7{\pm}0.7$ mg/dL, phosphorus $5.4{\pm}1.4$ mg/dL, and parathyroid hormone $324.2{\pm}342.8$ pg/mL. Conclusion : Primary glomerular disease was the most common cause of ESRD. CAPD was the most prevalent PD modality. Low and low average peritoneal transport type were common. Growth disturbance were noted in many patients. Some patients had hypertension even with anti- hypertensive drugs. Calcium-phosphorus levels were maintained adequately, but many patients had secondary hyperparathyroidism.

• Journal of agricultural medicine and community health
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• v.12 no.1
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• pp.36-53
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• 1987

It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Journal of Life Science
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• v.18 no.9
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• pp.1263-1270
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• 2008

The purpose of this study is to investigate the effect of exercise mode and anti-hypertensive drug responding status on the cardiovascular response and perceived exertion in acute coronary syndrome (ACS) patients. Seventy-five patients who participated in six-week exercise rehabilitation therapy performed a treadmill running and a cycle ergometer exercise at intensities of 60%HRR and 85%HRR respectively. Systolic and diastolic blood pressure, mean arterial blood pressure (MAP), rate pressure production (RPP), and ratings of perceived exertion (RPE) were measured. The results of cardiovascular response by the different exercise modes with moderate and intensive intensity of anti-hypertensive drug responder and nonresponder ACS patients were following: First cycle ergometer exercise induced significantly higher SBP, DBP, MAP, RPP and MAP than treadmill running exercise at the intensities of 60%HRR and 85%HRR in both anti-hypertensive responder and nonresponder ACS patients (p<0.05). Secondly anti-hypertensive nonresponder ACS patients had significantly higher DBP and MAP that anti-hypertensive responder ACS patients at all the exercise modes (p<0.05). Finally there was no difference of RPP between anti-hypertensive responder and nomresponder ACS patients, although anti-hypertensive nonresponder ACS patients showed higher blood pressure and RPP than anti-hypertensive responder ACS patients. In conclusion, cycle ergometer induced increased cardiovascular response at same intensities of treadmill running exercise and anti-hypertensive nonresponder ACS patients had even more increased cardiovascular response than anti-hypertensive responder ACS patients with no difference in perceived exertion during exercise. These results suggested that cycle ergometer exercise should be greatly careful with the risk of higher blood pressure, especially for those who are patients with hypertensive blood pressure.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.49-59
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• 2003

Objectives: This study was intended to provide basic data available for the establishment of comprehensive and systematic public medical service for older persons about their concurrent pathology and time span for their bedridden state, and thereby, the medical service, and individual cares they have received. Methods: The study subjects included 207 elderly residents of men and women aged over 65, who were in the bedridden state at home at the time of investigation in September of 2002 at 11 'Myon' in Kongju city, Chungchongnamdo Province. They were asked to respond to the questionnaires by using interviews at their homes. Results: Of the elderly population studied, the overall rate of bedridden states was 1.61%(1.46% in men and 1.71% in women) and there was an increasing tendency with age in both sexes. The causes for bedridden states indicated that hypertension and atherosclerosis accounted for 43.6 % of them in men, and lumbago neuralgia spinal disease 40.3% in women as the most frequent cause, respectively. The mean years of bedridden states were greater in men(4.81${\pm}$2.89) than women(4.98${\pm}$2.89). By age groups, both sexes showed an increasing tendency of time span with age. The items of care required for the bedridden showed that bathing was the most frequent and it was followed by toileting, dressing and feeding in a decreasing order of frequency. The number of care per one patient was 3.4 in men and 3.5 in women with the increased tendency with decreasing age Ain both sexes. Conclusions: Though the proportion of bed-ridden patients increased according to the increasing age, there are substantial limitations in reducing the prevalence of chronic diseases. Therefore, it is required to establish the appropriate measures, such as various resources of health care services for dealing with the steadily increasing rate of bed-ridden patients.

• Journal of Nutrition and Health
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• v.47 no.4
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• pp.247-257
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• 2014

Purpose: It is reported that most senior people consume a high carbohydrate diet, while a high carbohydrate diet could contribute to the risk of chronic disease. The aim of this study is to determine whether a high carbohydrate diet can increase the risk of chronic disease in elderly Koreans. Methods: Using the 2007-2009 Korean National Health Nutrition Examination Survey data, out of a total of 3,917 individuals aged 65 and above, final 1,535 subjects were analyzed, divided by dietary carbohydrate energy ratio into two groups of moderate carbohydrate ratio (MCR, 55-70%) and excessive carbohydrate ratio (ECR, > 70%). All data were processed after the application of weighted value, using a general linear model or logistic regression. Results: Eighty one percent of elderly Koreans consumed diets with carbohydrate energy ratio above 70%. The ECR group included more female subjects, rural residents, lower income, and lower education level. The ECR group showed lower waist circumference, lower diastolic blood pressure, and lower frequency of consumption of meat and egg, milk, and alcohol. The intake of energy and most nutrients, with the exception of fiber, potassium, vitamin A, and carotene, was lower in the ECR group compared to the MCR group. When analyzed by gender, the ECR group showed lower risk of dyslipidemia in male and obesity in female subjects, even though the ECR group showed low intake of some nutrients. No difference in the risk of hypertension, diabetes, and anemia was observed between the two groups in male or female subjects. Conclusion: This result suggested that a high carbohydrate diet would not be a cause to increase the risk of chronic disease in the elderly. Further study is needed in order to determine an appropriate carbohydrate energy ratio for elderly Koreans to reduce the risk of chronic disease.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.754-758
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• 2006

Background: Surgical role for acute coronary syndrome has been reduced in recent years due to development of drug eluting stent. We evaluated the surgical results of acute coronary syndrome in our hospital. Material and Method: Between January 2001 and August 2005, 416 patients underwent coronary artery bypass grafting (CABG) under diagnosis of non-ST-elevation acute coronary syndrome (NSTE ACS). Mean age was $61.8{\pm}9.0$ years and 276 (66.3%) patients were male. 324 (77.9%) patients had triple vessel disease and 92 (22.1%) had left main disease at angiographic study. 236 (56.7%) patients had hypertension and 174 (41.8%) had diabetes mellitus. Conventional on-pump CABG was performed in 194 patients (46.6%) and off-pump CABG in 222 (53.4%). Total arterial revascularization with no touch technique was done in 97 patients (23.3%). The number of total distal anastomosis was 1,306 and the number per patient was $3.21{\pm}1.71$. Result: Surgical mortality rate was 1.0% (4 patients) and postoperative complication rate was 15.6% (65 patients). Graft patency was checked at mean $3.7{\pm}7.6$ months (from 1 to 37 months) postoperatively with multi-directional computed tomography in 152 patients. Left internal mammary artery was patent in 95.3%, right internal mammary artery in 98.1%, radial artery in 92.2% and saphenous vein in 89.0%. Conclusion: The surgical treatment of NSTE ACS showed relatively low mortality rate and good graft patency rate. Further study is needed to compare the long term results with drug eluting stent.

• Korean Journal of Food Science and Technology
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• v.35 no.6
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• pp.1226-1232
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• 2003

Bamboo trees have been used for a long time as folk remedies for treatment of hypertension and stroke symptoms in Oriental regions. These pharmaceutical effects of bamboos look like to be related to its antioxidant capacity and phytochemicals in bamboos. To evaluate the antioxidative effects of bamboo trees, five kinds of bamboo varieties dominant in Korean peninsular were chosen and determined its total antioxidaive activities, free radical scavenging activities and nitrite scavenging activities by TEAC (Trolox Equivalent Antioxidant Capacity) assay, DPPH and Griess reagent assay using in vitro system, respectively. To evaluate the correlation between antioxidative activities and Maillard reaction during hot water extraction, contents of reducing sugar and total nitrogen and brown color intensity at 420 nm were determined. When total antioxidative activities, free radical scavenging activities and nitrite scavenging activities of five kinds of bamboo trees were compared, wang-dae (Phyllostachys bambusoides S. et Z.) showed the strongest effect among samples, although all kinds of extracts showed relatively strong effects against oxidation. The bamboo culms extract showed stronger antioxidative effects than that of bamboo leaves. In each fraction obtained from 70% ethanol extract, antioxidative effect were increased in order of dichloromethane>ethyl acetate>butanol>water>hexane fraction. In reducing sugar analysis of extracts, reducing sugar contents of water extracts were higher than that of 70% ethanol extracts and wang-dae water extract showed the highest level which was 708.92 mg/g. Total nitrogen contents of the extracts were $1.785{\sim}2.605\;mg%$ and contents in water extracts were lower than that in 70% ethanol extracts. Brown color intensity at 420 nm showed similar tendency with results in reducing sugar contents.

• Korean Public Health Research
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• v.44 no.4
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• pp.87-97
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• 2018

Background: Recently, the prevalence of obesity (body mass index [BMI] ${\geq}25kg/m^2$) has been increasing rapidly worldwide over a short period. In Korea, the prevalence of obesity has also increased rapidly due to the rapid socio-economic development and lifestyle changes, with differing patterns according to gender. This study aimed to compare the change in obesity prevalence according to gender among the adult population in Korea using representative data, the National Health Check-up Database (NHCD), to follow-up individuals who had undergone checkups during both years in Korea (2011~2013). Methods: To analyze the changes in obesity prevalence in the recent two years, data regarding men and women who had undergone health check-ups in both two years (2011, 2013) were extracted. The final study population comprised 144,934 persons: 83,604 (58%) males and 61,330 (42%) females. Chi-square test within a univariate analysis, and the level of factor difference was verified with t-test, one-way ANOVA and multiple comparison. Results: In 2011, one out of three participants was obese (BMI ${\geq}25kg/m^2$; male, 37.7%; female, 27.3%) and more than half of the subjects were overweight (BMI ${\geq}23kg/m^2$; male, 65.6%; female, 50.4%) requiring obesity management. For the two years, the BMI of the participants significantly increased (p < .0001) and the prevalence of obesity increased among both males and females. The prevalence of obesity was higher among both genders with a longer duration of smoking, more smoking, family history of hypertension, and family history of diabetes. However, residence, income level, drinking status, psychiatric disorder, disability status and severity of disability were the opposite gender. Conclusion: In the analysis of data, the prevalence of obesity among both men and women was increasing. The degree of change in the prevalence of obesity among men and women was different in each variable. Thus, it will need to consider gender in developing health policies for obesity mediation and to provide integrated healthcare and management for those people.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.141-158
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• 1994

To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.