• Korean Journal of Health Education and Promotion
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• v.25 no.3
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• pp.167-181
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• 2008

The prevention of life-style related diseases is an increasingly important issue in Japan, because not only have the number of patients with life-style related diseases increased but also medical care costs. This paper gives recent strategies for the prevention of cardiovascular diseases through life-style modification. Health objectives for the year 2010, called "Healthy Japan 21", were established in 2000 by the Ministry of Health, Labour and Welfare and the Health Promotion Act was enacted in 2002 to promote this health policy. However, the prevention efforts for life-style related diseases have not been effective in regard to the evaluation of the strategy objectives. The reform of the medical care system which included a new nationwide prevention strategy for life-style related diseases was presented in 2006. The new strategy starting from April 2008 included a "specific health checkup" and "specific health education" for those with metabolic syndrome. The specific health checkup is used to screen people according to criteria of the metabolic syndrome and divide them into 3 groups. These groups will receive specific health education. The purpose of this strategy is the early detection of those who have cardiovascular risk factors, and the early management of the clustering of cardiovascular risk factors of obese people aged 40-74 years old. It is mandatory for every insurer to conduct a specific health checkup and specific health education under the new Act. The implementation rate of the specific health checkup and the specific health education, and a reduction rate of individuals with metabolic syndrome among insured people will be evaluated every year. The national objective is to increase the rate of those undergoing the specific health checkup to 80% and the rate of those receiving the specific health education to 60% by the year 2015. The national objective also targeted a reduction rate of 25% for those with metabolic syndrome. This new strategy will be the biggest intervention trial in the world, and it will produce a big health care market in Japan. Not only public administrative institutions but also private institutions are now preparing to take part in this new strategy. However, various tasks remain, such as training more professionals in health education, developing more evidence based practices, and encouraging cooperation with various sectors, to enforce this new strategy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.3
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• pp.520-534
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• 2018

This study was conducted to understand the conceptual definition and characteristics of health inequality. To accomplish this, we analyzed data collected from 14 participants as well as from available literature regarding health inequality using the hybrid model introduced by Schwartz-Barcott and Kim. We categorized health inequality into nine attributes in three dimensions. These dimensions included "target", "precede", and "result," corresponding to the target, cause and consequence of health inequality, respectively. Specifically, we define health inequality as individuals, families, communities, socio-economic, or geographically distinct demographic groups that are treated unfairly and result in several problems such as loss of quality of life, reduction of survival rate, or aggravation of a disease due to (i) poor treatment by a hospital (ii) irregular meals, (iii) desperate need for work (for money), (iv) expensive medical care costs, (v) qualitative differences in medical care by regional groups (vi) the lack of knowledge regarding disease (vii) and inadequate health care because of lack of time. As a result of this unfair treatment, human rights violation occurs. The major contribution from this paper is that we provide a guideline for establishing strategies to reduce health inequality by identifying the concept of health inequality. Based on this study, we recommend development of an educational program to reduce health inequalities.

• The Journal of the Convergence on Culture Technology
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• v.1 no.4
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• pp.87-101
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• 2015

This study was aimed to make data how much spent money of medical utilization and direct medical cost. In order to research we were using Korea Health panel 2012 Statistics which data contained Diabetes mellitus client 812 people in age 19. The method of this study was emergency cost, admission medical cost, out patient department cost(client own due, National Health insurance service due, not insurance fee). The result of this study, Diabete Mellitus client were using 198 times during 1 year per 100, total medical direct cost were 859,942 won, 447,359 won, 363,255,508. And admission times were 5.6 times per year, total direct cost was 772,240 won, 4,061,982 won, and 3,298,329,384 won, and out patient clinic using number was 10 times, medical cost total direct cost containing total direct cost was 11,978 won, 26,020 won, and 21,129,240 won. From this research we conclusion that the occurrence of diabetes mellitus can be increased medical cost and direct medical cost and it can be huge burden to client including their family and quality of life in the future. We suggest that in order to prevention and management of diabetes mellitus healthy diet, activity, blood sugar, and blood management should be encouragement.

• Journal of Information Technology Services
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• v.17 no.1
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• pp.105-119
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• 2018

The healthcare business is growing as a global core business because of the phenomenon of global aging, as well as in South Korea, skyrocketing health care costs accordingly, and changing the paradigm from treatment to the prevention-centered medical service. Especially, as the digital healthcare service stands out as a solution, major countries actively promote and support policies at the government level. Thus, this study will present attributes of a market-oriented service that would vitalize the digital healthcare service industry by investigating major attributes of the digital healthcare service. To analyze the relationships of the influences of attributes, this study used Interpretive Structural Modeling. As a result of literature research and ISM, this study can understand the eight basic attributes of the digital healthcare service (network scalability, context awareness, connection among information platforms, cost, trust, security, ease of use, usefulness) and analyze the relationships of the influences among the attributes. In addition, as this study finds some significant differences in Order Winner and Order Qualifier between the experts' group (security) and the users' group (trust, ease of use, usefulness), It provides meaningful implications for revitalization and promotion of digital healthcare service industry.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.413-420
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• 2016

Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

• Korean Journal of Health Education and Promotion
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• v.26 no.2
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• pp.149-155
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• 2009

Metabolically obese but normal weight(MONW) syndrome is characterized, with potentially increased risks for development of the insulin resistance or metabolic syndrome despite their normal body mass index(BMI) < 25 kg/m2. Such characteristics could confer upon MONW individuals a type 2 diabetes mellitus and cardiovascular diseases(CVD) risk however, research on MONW is scarce. MONW individuals have metabolic disturbances typical of obese persons and are identified by having a high amount of visceral fat, a low BMI, a high fat mass, a low lean body mass, low insulin sensitivity, and high triglyceride concentrations. The purpose of this study is to review several markers as potential modulators in individuals displaying the "MONW". Body fat appears to be functionally comparable with a dynamic endocrine organ, producing and secreting various adipocy tokines, such as leptin, adiponectin, CRP, tumor necrosis factor(TNF-), interleukin(IL)-6, all of which play an important role in the onset of cardiovascular disease, and insulin resistance. Otherwise, physical activity and a lower inflammation state might be helped to reduce the number of persons at risk of diabetes, CVD complications, or premature mortality. We should provide a method to optimal treatments resolving the emerging public health problem to prevention of MONW by providing guideline for physical activity as an optimal treatment for the MONW Korean. Furthermore we expect to develop a new strategy to manage MONW Korean in this society in terms of reducing medical costs and enhancing public health care for uprising population with MONW.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.127-129
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• 2018

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

• Biomedical Science Letters
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• v.28 no.1
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• pp.1-8
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• 2022

Total joint arthroplasty is a successful joint replacement treatment that improves joint function and overall quality of life and provides pain relief. However, the prevalence of periprosthetic joint infection (PJI) has become prevalent with the rise in the incidence of arthroplasty surgery. PJI occurs rarely following arthroplasty however presents with serious complications, including high morbidity. The identification of causative microorganisms is essential for the treatment of PJI. Managing PJI requires complex treatment strategies, including long-term antibacterial treatment, and significant medical costs can be incurred. The American Academy of Orthopedic Surgeons, the Centers for Disease Control and Prevention, and Surgical Care Improvement Project guidelines recommend that prophylactic antibiotics such as first-generation cephalosporins be infused completely 1 hour before surgical incision. However, these preventative antibiotics are very limited, therefore risk factors must be identified to diagnosis and treat patients effectively. Moreover, determining antimicrobial susceptibility during artificial joint surgery and choosing the most appropriate treatment strategy following an accurate diagnosis of microbial infections are essential. In the present review, we describe the management, including the etiology, diagnosis, and classification of PJI, and approaches to its diagnosis using the available novel molecular diagnostic methods.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.291-296
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• 2013

Purpose: Prolonged ventilation leads to a higher incidence of ventilator-associated pneumonia (VAP), resulting in weaning failure and increased medical costs. The aim of this study was to analyze clinical results and prognostic factors of VAP in patients with blunt chest trauma. Methods: From 2007 to 2011, one hundred patients undergoing mechanical ventilation for more than 48 hours were divided into two groups: a VAP-negative group, (32 patients, mean age; 53 years, M:F=25:7) and a VAP- positive group, (68 patients, mean age; 60 years, M:F=56:12). VAP was diagnosed using clinical symptoms, radiologic findings and microorganisms. The injury severity score (ISS), shock, combined injuries, computerized tomographic pulmonary findings, transfusion, chronic obstructive lung disease (COPD), ventilation time, stay in intensive care unit (ICU) and hospital stays, complications such as sepsis or disseminated intravascular coagulation (DIC) and microorganisms were analyzed. Chi square, t-test, Mann-Whitney U test and logistic regression analysies were used with SPSS 18 software. Results: Age, sex, ISS, shock and combined injuries showed no differences between the VAP - negative group and - positive group (p>0.05), but ventilation time, ICU and hospital stays, blood transfusion and complications such as sepsis or DIC showed significant differencies (p<0.05). Four patients(13%) showed no clinical symptoms eventhough blood cultures were positive. Regardless of VAP, mortality-related factors were shock (p=0.036), transfusion (p=0.042), COPD (p=0.029), mechanical ventilation time (p=0.011), ICU stay (p=0.032), and sepsis (p=0.000). Microorgnisms were MRSA(43%), pseudomonas(24%), acinetobacter(16%), streptococcus(9%), klebsiela(4%), staphillococus aureus(4%). However there was no difference in mortality between the two groups. Conclusion: VAP itself was not related with mortality. Consideration of mortality-related factors for VAP and its aggressive treatment play important roles in improving patient outcomes.