• Journal of Oriental Neuropsychiatry
• /
• v.26 no.3
• /
• pp.293-306
• /
• 2015

Objectives: The purpose of this study is to identify predictors of clinical efficacy of oriental medical treatment for patients with panic disorder. Methods: We analyzed medical records of 41 patients who were diagnosed with panic disorder through DSM-IV or ICD-10 by 2 oriental medical neuro-psychiatrists. We performed frequency analysis of demographic characteristics in patients with panic disorder, and assessed the correlation between the psychological scales by Pearson correlation. Repeated measures ANOVA were used to compare the psychological scales during the treatment; and Single regression analysis was used to analyze the factors that have correlation to improvement of panic disorder by oriental medical treatment. Psychological scales used in the study were STAI-X-1/2, STAXI-S/T, BDI2, BAI, BSQ, PAS, ASI, LOT-R, SWLS, LSES and LSMS. Results: Patients' demographic characteristics indicated that there were twice more female than male patients; furthermore, there was a high ratio of patients in their 20s and 30s, with the highest percentage of onset-age in the 20s and average duration of panic disorder from 1~5 years. More than half of the total patient cohort comprised of those who had panic disorder with agoraphobia and major depressive disorder; in addition, major accompanied symptoms were dyspepsia, chest discomfort and headache. After treatment, most scores of psychological scales were significantly reduced, and correlation between the psychological scales was significant. Furthermore, we identified some factors that were significantly correlated to improvement of panic disorder by oriental medical treatment. Conclusions: In conclusion, treatment of panic disorder with oriental medicine was clinically efficient and improved the quality of life.

• Health Policy and Management
• /
• v.20 no.2
• /
• pp.128-143
• /
• 2010

Objectives : This study aims to estimate the oral antihyperglycemic medications adherence among ambulatory care with adult type 2 diabetes patients and to identify factors affecting the medication adherence in Korea. Methods : This study used the Korean National Health Insurance Database. Study population was 40,082 patients who were 20 years of age or older and first diagnosed with type 2 diabetes (ICD-10: E11) in 2004. The patients were followed up for two years in order to measure adherence with oral antihyperglycemic medications. The level of medication adherence was measured by the medication possession ratio (MPR). Results : The average MPR in the study population was 49.5%. The appropriate adherence rate (MPR$\geq$80%) was 29.4% and showed variation according to the characteristics of individual patients. Multiple logistic regression analysis revealed that the odds of appropriate adherence increased with female (OR:1.21, CI:1.14-1.27), older age, increasing ambulatory care visits, health insurance (OR:1.53, CI:1.33-1.76), decreasing ambulatory care providers, using a specialized general hospital as their main attending medical institution (OR:10.08, CI:8.96-11.33), having co-morbidity, using polytherapy (OR:1.07, CI:1.01-1.13). Conclusions : The medications adherence for patient with type 2 diabetes is low in Korea, and shows variation according to the characteristics of patients. For proper management of diabetes, health care policy is expected to be enacted to improve medications adherence continuously. In particular, more intensive management is needed for patients with low medications adherence. Also, health care policy makers need to develop the program to induce health care utilization by a patient to be more concentrated with the same provider.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.14
• /
• pp.5903-5906
• /
• 2015

Background: Cholangiocarcinoma (CCA) is a serious public health problem in the Northeast of Thailand. CCA is considered to be an incurable and rapidly lethal disease. Knowledge of the distribution of CCA patients is necessary for management strategies. Objectives: This study aimed to utilize the Geographic Information System and Google $Earth^{TM}$ for distribution mapping of cholangiocarcinoma in Satuek District, Buriram, Thailand, during a 5-year period (2008-2012). Materials and Methods: In this retrospective study data were collected and reviewed from the OPD cards, definitive cases of CCA were patients who were treated in Satuek hospital and were diagnosed with CCA or ICD-10 code C22.1. CCA cases were used to analyze and calculate with ArcGIS 9.2, all of data were imported into Google Earth using the online web page www.earthpoint.us. Data were displayed at village points. Results: A total of 53 cases were diagnosed and identified as CCA. The incidence was 53.57 per 100,000 population (65.5 for males and 30.8 for females) and the majority of CCA cases were in stages IV and IIA. The average age was 67 years old. The highest attack rate was observed in Thung Wang sub-district (161.4 per 100,000 population). The map display at village points for CCA patients based on Google Earth gave a clear visual deistribution. Conclusions: CCA is still a major problem in Satuek district, Buriram province of Thailand. The Google Earth production process is very simple and easy to learn. It is suitable for the use in further development of CCA management strategies.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.8
• /
• pp.4591-4594
• /
• 2013

Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, there are no documented population-based survival rates of Malaysian women for breast cancers. This populationbased retrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre, Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the period from $1^{st}$ January 2000 to $31^{st}$ December 2005. Cases were captured by ICD-10 and linked to death certificates to identify the status. Only complete data were analysed. Survival time was calculated from the estimated date of diagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan-Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed. The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survival time of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) and Malays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still low for the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary to enhance the strategies for early detection and intervention.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.sup3
• /
• pp.93-99
• /
• 2016

Completeness is an important indicator of data quality in cancer registry programs. This study aimed to estimate the completeness of registered cases in a population based cancer registry program implemented in five provinces of Iran. Capture-recapture methods were used to estimate the number of cases that may have been missed and to estimate rates of completeness for different categories of age, year, and sex. The data used for this study were obtained from three sources: 1) National Pathology Database; 2) National Hospital Discharge Database; and 3) National Death Registry Database. The three sources were linked and duplicates were identified based on first name, last name, father's names, and date of birth, ICD code, and case's residency address using Microsoft Excel. Removing duplicates, the three sources reported a total of 35,643 cases from March 2008 to March 2011. Running many different multivariate models of capture-recapture and controlling for source dependencies revealed an overall under-reporting of 49% in all five registries combined. The estimated completeness differed based on age, sex, and year. The overall completeness was higher for males than females (71.2% for males and 59.9% for females). Younger age had lower rates of completeness compared to older age (38.1% for <40 years, 55.4% for 40-60 years, and 76.7 for >60 years). The results of this study indicated a moderate to severe (depending on the age, sex and year) degree of completeness in the population based cancer registration of Iran.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.2783-2787
• /
• 2013

To assess the risk of cancer incidence after medical radiation exposure for coronary artery disease (CAD), a retrospective cohort study was conducted based on Taiwan's National Health Insurance Research Database (NHIRD). Patients with CAD were identified according to the International Classification of Diseases code, 9th Revision, Clinical Modification (ICD-9-CM), and their records of medical radiation procedures were collected from 1997 to 2010. A total of 18,697 subjects with radiation exposure from cardiac imaging or therapeutic procedures for CAD were enrolled, and 19,109 subjects receiving cardiac diagnostic procedures without radiation were adopted as the control group. The distributions of age and gender were similar between the two populations. Cancer risks were evaluated by age-adjusted incidence rate ratio (aIRR) and association with cumulative exposure were further evaluated with relative risks by Poisson regression analysis. A total of 954 and 885 subjects with various types of cancers in both cohorts after following up for over 10 years were found, with incidences of 409.8 and 388.0 per 100,000 person-years, respectively. The risk of breast cancer (aIRR=1.85, 95% confidence interval: 1.14-3.00) was significantly elevated in the exposed female subjects, but no significant cancer risk was found in the exposed males. In addition, cancer risks of the breast and lung were increased with the exposure level. The study suggests that radiation exposure from cardiac imaging or therapeutic procedures for CAD may be associated with the increased risk of breast and lung cancers in CAD patients.

• Clinical and Experimental Pediatrics
• /
• v.60 no.7
• /
• pp.221-226
• /
• 2017

Purpose: Escherichia coli sequence type (ST) 131, a multidrug-resistant clone causing extraintestinal infections, has rapidly become prevalent worldwide. However, the epidemiological and clinical features of pediatric infections are poorly understood. We aimed to explore the characteristics of ST131 Escherichia coli isolated from Korean children with urinary tract infections. Methods: We examined 114 uropathogenic E. coli (UPEC) isolates from children hospitalized at Chung-Ang University Hospital between 2011 and 2014. Bacterial strains were classified into STs by partial sequencing of seven housekeeping genes (adk, fumC, gyrB, icd, mdh, purA, and recA). Clinical characteristics and antimicrobial susceptibility were compared between ST131 and non-ST131 UPEC isolates. Results: Sixteen UPEC isolates (14.0%) were extended-spectrum ${\beta}-lactamase$ (ESBL)-producers; 50.0% of ESBL-producers were ST131 isolates. Of all the isolates tested, 13.2% (15 of 114) were classified as ST131. There were no statistically significant associations between ST131 and age, sex, or clinical characteristics, including fever, white blood cell counts in urine and serum, C-reactive protein, radiologic abnormalities, and clinical outcome. However, ST131 isolates showed significantly lower rates of susceptibility to cefazolin (26.7%), cefotaxime (40.0%), cefepime (40.0%), and ciprofloxacin (53.3%) than non-ST131 isolates (65.7%, 91.9%, 92.9%, and 87.9%, respectively; P<0.001 for all). ESBL was more frequently produced in ST131 (53.3%) than in non-ST131 (8.1%) isolates (P<0.01). Conclusion: ST131 E. coli isolates were prevalent uropathogens in children at a single medical center in Korea between 2011 and 2014. Although ST131 isolates showed higher rates of antimicrobial resistance, clinical presentation and outcomes of patients were similar to those of patients infected with non-ST131 isolates.

• Health Policy and Management
• /
• v.19 no.1
• /
• pp.49-61
• /
• 2009

Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.

• Journal of the Korean Society of School Health
• /
• v.9 no.2
• /
• pp.197-204
• /
• 1996

Based generally on the socio-economic status of the surrounding areas of Seoul daily health records from 6 randomly sampled primary schools were analyzed to evaluate the health problems of school children in 1992. Diseases were classified into 11 categories according to ICD-9. The mean number of visits to health care rooms during school per student was 0.95 during 215 school days from February to December in 1992 and the mean number of daily visits was 10.12. Female students visited health rooms more frequently than male students. The total spell base incidence rate was 947.3 per 1,000 students in a year; the incident rate from digestive diseases was 342.1; from injuries it was 333.6; and from respiratory diseases, it was 243.9. 85% of all diseases were from trauma, gastric symtoms, and common colds. The most frequent diseases for male students resulted from trauma and for female students from gastric symtoms. The average incident rate was highest in the Kangnam area, and the lowest in the Kangbuk area and this result is statistically significant. The incident rates of 5th and 6th graders were significantly higher than the rest. Emergency cases refered to hospital were 140(1.07%), and drugs used for treatment consisted of digestives, drugs for common colds, analgesics and antipyretics, eye drops, and external ointments for trauma. In conclusion the above results suggest that the school health service program and health education program should be based on the health status of school children.

• Journal of Digital Convergence
• /
• v.16 no.7
• /
• pp.199-211
• /
• 2018

Ever since Korea was geopolitically divided into North and South Korea in the 1940s, South Korea has depended on maritime transportation for global trade and logistics. Now, however, South Korea is preparing to develop a new global route for trans-Eurasia logistics passing through North Korea. Even though there are difficulties to overcome, South Korea expects that a new overland route, shorter than the existing seaways in the Europe-Asia section, will bring more frequent trade with more rapid and cost-effective logistics services in the future. Related to this issue, this study aims to proactively analyze dynamic logistics changes in South Korea when a trans-Korea railway is developed and linked with the trans-China railway and the trans-Siberian railway. This study employed a system dynamics simulation approach to model the logistics system in South Korea. The simulation results indicated that the traffic of the Uiwang inland container depot near the capital area may increase but the traffic of the Port of Busan may decrease. With supplementary research, consequently, follow-up studies on adjusting the traffic capacity in Korea are required to attain successful trans-Eurasia logistics by rail.