• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.452-458
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• 1999

Objectives: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. Methods: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox's model were used for potentially diseased group, other members, and total subjects, respectively. Results: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk. while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. Conclusions: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.

• Research in Community and Public Health Nursing
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• v.11 no.1
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• pp.21-36
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• 2000

The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.

• Neonatal Medicine
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• v.16 no.1
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• pp.25-35
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• 2009

Purpose: The characteristics of hospitalized patients in neonatal intensive care units (NICUs), including hospitalization costs (HC) and National Health Insurance (NHI) status were studied. Methods: We gathered the following data from 7 hospitals in Korea during 2006: the distribution of patients according to birth weight (BW), and the duration of the hospital stay according to BW and He. Results: The patients who were admitted to the NICU consisted of high-risk neonates, including low birth weight or premature neonates, which comprised 50% of all neonates admitted to the NICU. The duration of hospitalization was 75-90 days for neonates with BW <1,000 g, 45-60 days for neonates with BW between 1,000 and 1,499 g, and approximately 15 days for neonates with BW between 2,000 and 2,499 g. The portion of the HC covered by the NHI was 77.1%, 22.9% of the total HC was not covered by the NHI (19.5% was included in the list, but not covered by the NHI and 3.4% was not listed, but covered by the NHI). The average total HC per person was 4,360,000 won, and the HC covered and not covered by the NHI were 3,677,000 won and 1,007,000 won, respectively. The mean HC were as follows; 35,000,000 won for a BW <500 g, 18,000,000 won for a BW between 500 and 999 g, 16,000,000 won for a BW between 1,000 and 1,499 g, and 4,200,000 won for a BW between 1,500 and 1,999 g. Conclusion: Not only premature, but also ill neonates were under the care of the NICU. The HC increased as the BW decreased and the hospitalization period increased. The proportion of the patient's financial burden is >25% of the total He. For this matter, additional NHI is needed.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.91-102
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• 1993

This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered questionnaires completed by housewives. The survey was conducted from March 1 to May 31, 1992. The mean age was 31.1 years in the poor area and 37.1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The average monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%), while hospital and clinic(37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2.800 Won in the poor area and 6,300 Won in the control area.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.482-488
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• 2002

Purpose : We performed this study to evaluate the diagnostic usefulness of endoscopic finding of nodular gastritis, CLO and HpKit test for H. pylori infection in children. Methods : Gastroduodenal endoscopy and mucosal biopsy were performed on 212 children who visited our hospital between Jul. 1999 and May 2000 due to abdominal pain. We performed CLO and HpKit test for H. pylori with the time interval of 15, 30 minutes, 1, 2, 3, 24, 48, 72, 96, 120 and 144 hours. Histological examination of H. pylori was made by H-E or Alcian yellow stain with biopsy specimens. Sensitivity, specificity, positive predictive and negative predictive value of nodular gastritis, CLO and HpKit test were calculated from the analysis of above data. Results : Sensitivity and specificity of 3 hour-CLO test was 68.4% and 100% respectively. Sensitivity and specificity of 3 hour-HpKit test was 65.8% and 100% respectively. No significant difference in sensitivity and specificity was found between in 3 hour-CLO and HpKit test(P>0.05). Sensitivity of CLO test increased as time lapsed, but corresponding specificity did not decrease as time lapsed(sensitivity and specificity at 144 hours : 89.5% and 94.8% respectively). However, sensitivity of HpKit test increased as time lapsed, but specificity markedly decreased. Sensitivity and specificity of the nodular gastritis was 78.9% and 93.7% respectively. Conclusion : Both CLO and HpKit test have relatively low sensitivity and specificity for the detection of H. pylori in 3 hours of testing in children. The endoscopic finding of nodular gastritis is another good standard in the diagnosis of H. pylori infection in children.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.11
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• pp.66-79
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• 2016

A discussion has recently emerged over the increase of approvals of K-REITs, which is concluded on the basis of how to raise funds for business activity, fulfill the expected rate of return and maximize the management of managing investment funds. In addition, corporations need to acknowledge the necessity of the capital structure reflected in the current economic environment and decision-making processes. This research analyzed the characteristics by investment types and influence factors about the debt ratio of K-REITs. The data were collected from general management about business state, investment, and finance from 2002 to 2015 in K-REITs (except for the GFC period of 2007~2009). The results of the research demonstrated the high ratios of the largest shareholder characteristics, which are corporation, pension funds, mutual funds, banks, securities, insurance, and, recently, the increasing ratio of the largest shareholder and major stockholder. The investment of K-REITs is increasing the role of institutional investors that take a leading development of K-REITs. The behaviors of simultaneous investment of institutional investors were analyzed to show that they received higher interest rates than other financial institutions and ran in parallel with attraction and compensation. The results of the multiple regressions analysis, utilizing variables about debt ratio were as follows. The debt ratio showed a negative (-) relation that profitability is increasing, which matches the pecking order theory and trade off theory. On the other hand, investment opportunities (growth potential) showed a negative (-) relation and assets scale that indicated a positive (+) relation. The research results are reflected as follows. K-REITs focused on private equity REITs more than public offering REITs, and in the case of financing the capital of others, loan capital is operated under the guarantee of tangible assets (most of real estate) more than financing of the stock market. Further, after the GFC, the capital of others was actively utilized in K-REITs business, and the debt ratio showed that the determinant factors by the ratio and characteristics of the largest shareholder and investment products.

• Journal of Korean Home Economics Education Association
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• v.29 no.2
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• pp.23-39
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• 2017

The Purpose of this study is to present the basic data for selecting and improving the safety education contents which help practically middle school students through analysis of contents of safety education in 'field of home life' of 2009 revised middle school textbooks. The subjects of analysis are 12 types of middle school textbooks: in total 24 books written by 12 publishers in terms of the revised curriculum in 2009. The analysis criteria is developed by the researcher referring to preceding studies regarding safety education based on the seventh safety education standard presented by the Ministry of Education (2015). With such analysis criteria, all words related to the contents of the safety education of analysis criteria were extracted from each textbook, such as words directly mentioned as 'safety', words mean as 'psychological safety' and 'happy life', words related to 'attention', 'note', 'stability' etc. Under the analytic frame of safety education contents according to a home economics textbook, content analysis method was used for producing the frequency and percent of those words. The textbook analysis shows that the number of pages regarding safety education is 336.3 pages, as 9.8% in total 3,412 pages of 12 types of technology and home economics textbooks. As following the analysis of each textbook volume of the proportion in the contents related to safety education, 224.9 pages are on the first volume and 111.9 pages are on the second volume. As grades increase from year one to year three, the proportion of safety education in home economics textbooks is decreased. The highest number of safety education contents unit is 'Self-management of youth' which includes three parts of safety education. In the case of a unit for emphasizing practice, experience and practical exercise such as 'Life of youth' and 'Practice of eco-living', safety education content in the area of 'life safety' are mostly contained. Safety accidents related to the most student experienced, Household accidents (1.4%) and experiment or practice accidents (0.3%) are presented in a low figure. The contents of universal housing and school violence are duplicated on first and second volume of text. The most presented safety education content in the 12 types of textbooks are proper sexual attitude, dietary problems, family conflict and food choice. The least common contents are dangerous drugs, family welfare, internet addiction and industrial accident compensation insurance. As this study is to analyze 12 textbooks developed in 2009 revision curriculum, it is necessary to compare it with the textbook written by the revised curriculum in 2015 and to clarify the contents system of safety education and to avoid duplication of contents. In addition, it is necessary to develop and distribute a safety education program that can support textbooks.

• Journal of Gastric Cancer
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• v.9 no.4
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• pp.172-176
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• 2009

Purpose: The rapid urease test is a rapid and reliable method for diagnosing Helicobacter pylori infection. However it requires gastric mucosal biopsies during endoscopy, and the test is not covered by national health insurance for patients with gastric cancer. So, we introduced an alternative method for a rapid urease test using back-table gastric mucosal biopsies from gastrectomy specimen. Materials and Methods: Ninety gastric cancer patients underwent an anti H. pylori IgG ELISA test and gastrectomy. Just after gastrectomy, two gastric mucosal biopsies from the prepyloric antrum and lower body of the gastrectomy specimen were taken from the back table in the operative room, and these were fixed immediately with the rapid urease test kit, and the color change was monitored for up to 24 hours. In this study, H. pylori infection was defined as positive when the serology or rapid urease test showed positive results. Results: The positive rate of the rapid urease test and serology was 91.1% and 77.8%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid urease test and serology were 94.3 and 80.5%, 100 and 100%, 100 and 100%, and 37.5 and 15%, respectively. The accuracy of the rapid urease test was higher than that of serology (94.4 vs. 81.1%, respectively). The rapid urease test showed a higher rate of detecting H. pylori infection than that of serology (McNemar's test, P=0.019). Conclusion: The result of the rapid urease test using back-table gastric mucosal biopsies from a gastrectomy specimen is comparable to the reference data of the conventional rapid urease test using gastric mucosal endoscopic biopsies. Therefore, it can be an alternative diagnostic method for H. pylori infection.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.1
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• pp.32-39
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• 2006

Objectives : The aim of this study was to examine the developmental and clinical characteristics associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed a parent questionnaire consisting of a Child Behavior Checklist(CBCL). Data related to the prenatal, perinatal and developmental history, past and current medical history were collected. Ninety-three normal students were selected as the control group. Results : The nocturnal enuresis group attained diurnal and nocturnal urinary control significantly later than those in the normal control group.49.2% of the children with nocturnal enuresis had the family history of nocturnal enuresis. Daytime incontinence was present in 41.3% of the nocturnal enuresis group. The percentages of sleep-related disturbances were significantly higher in the nocturnal enuresis group when compared to the normal control group.42.6% of the children with nocturnal enuresis experienced pharmacotherapy, and 0.4% experienced enuresis alarms. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have a high genetic load and a possibility of developmental delay, which supports the neurodevelopmental point of view with regard to the etiology of nocturnal enuresis. The physicians in Korea prefer pharmacological interventions to alarm interventions in treating Korean children with nocturnal enuresis.

• 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.