• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.297-308
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• 2021

Objective : Shunt infection is a common complication while treating hydrocephalus. The antibiotic-impregnated shunt catheter (AISC) was designed to reduce shunt infection rate. A meta-analysis was conducted to study the effectiveness of AISCs in reduction of shunt infection in terms of age, follow-up time and high-risk patient population. Methods : This study reviewed literature from three databases including PubMed, EMBASE, and Cochrane Library (from 2000 to March 2019). Clinical studies from controlled trials for shunt operation were included in this analysis. A subgroup analysis was performed based on the patient's age, follow-up time and high-risk population. The fixed effect in RevMan 5.3 software (Cochrane Collaboration) was used for this meta-analysis. Results : This study included 19 controlled clinical trials including 10105 operations. The analysis demonstrated that AISC could reduce the infection rate in shunt surgery compared to standard shunt catheter (non-AISC) from 8.13% to 4.09% (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.40-0.58; p=0.01; I2=46%). Subgroup analysis of different age groups showed that AISC had significant antimicrobial effects in all three groups (adult, infant, and adolescent). Follow-up time analysis showed that AISC was effective in preventing early shunt infections (within 6 months after implant). AISC is more effective in high-risk population (OR, 0.24;95% CI, 0.14-0.40; p=0.60; I2=0%) than in general patient population. Conclusion : The results of meta-analysis indicated that AISC is an effective method for reducing shunt infection. We recommend that AISC should be considered for use in infants and high-risk groups. For adult patients, the choice for AISC could be determined based on the treatment cost.

• Journal of Korea Entertainment Industry Association
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• v.15 no.8
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• pp.213-231
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• 2021

Due to the absence of rehabilitation sports service systems linked to post-discharge medical measures and rehabilitation, disabled people cannot participate in physical activities suitable for individual disability types, characteristics, and physical functions. In December 2017, the Act on the Rights of Health for the Disabled) was implemented to provide an institutional basis for disable people to address their needs for rehabilitation sports. Based on related studies conducted in Korea, this study aims to collect the results of a demand survey conducted on experts who are rehabilitation sports service providers and analyze the demand for rehabilitation sports services from a policy perspective. This study extracts the needs of experts presented in the literature and presents the extracted content as an inductive content analysis. The criteria for selecting the literature were selected based on studies related to "adaptive physical activity and exercise," "sports for all for the disabled," and "rehabilitation sports" conducted in the Republic of Korea, including the results of a demand survey on experts. The study results were categorized into seven categories (perception of sports activities, programs, leaders, facilities, accessibility, cost/support/financial resources, and others) of field experts who are rehabilitation sports service providers. In a future study, it will be necessary for people with disability, who are consumers who will provide actual services, to identify problems at the disabled sports site and come up with measures to improve them.

• Health Policy and Management
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• v.4 no.1
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• pp.49-76
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• 1994

Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.

• Korean journal of applied entomology
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• v.61 no.4
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• pp.675-688
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• 2022

Produced by steaming mature silkworms, HongJam is a natural functional food with various health-promoting effects. The current standard HongJam production protocol involves freezing and freeze-drying steamed mature silkworms for convenient long-term storage and/or selling it to customers. However, freeze-drying HongJam requires a range of processes and costs, which have contributed to its high resale value. In this study, we found that the cost of manufacturing HongJam powder could be reduced by homogenizing steamed mature silkworms using a high-speed blender and digital homogenizer, followed by spray drying. After the homogenized HongJam solution was digested by directly adding food-graded proteases, food-graded protease-digested homogenized HongJam solution was spray-dried. Food-graded digested protease or non-digested homogenized HongJam solutions could be used to produce food for special medical use for patients with general or specific diseases. This more efficient HongJam processing protocol proposed in this study can facilitate the development of sericulture farms and related industries by reducing the production costs of HongJam and its associated products.

• Therapeutic Science for Rehabilitation
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• v.11 no.1
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• pp.35-47
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• 2022

Objective : In this study, we conducted a questionnaire survey of occupational therapists to examine their perceptions on and willingness to provide telerehabilitation dementia prevention education. Methods : From March 13 to 19, 2021, a questionnaire survey targeting occupational therapists in Busan, Ulsan, and Gyeongnam was conducted. 100 questionnaires were distributed but only 70 were collected. The collected data were subjected to frequency analysis and descriptive statistics using the statistical program SPSS version 23.0. Results : The average scores by region were as follows. The average compatibility score was highest at 3.92 score, intention to providing education, doctors 3.89 score, community-centric rehabilitation awareness 3.81 score, cost saving 3.78 score, perceiver usefulness 3.75 score, accessibility 3.62 score, the quality of telerehabilitation service was in order of 3.49 score. Conclusion : All items asking whether occupational therapists participate in community-centered rehabilitation and non-face-to-face dementia prevention education programs showed high scores, indicating the willingness to participate actively. In the future, in addition to follow-up research on the implementation of telerehabilitation dementia prevention education, measures for improving accessibility within the local and national government should be discussed.

• 한국노년학
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• v.39 no.2
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• pp.305-323
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• 2019

In recognition of the increasing social attention paid to the notion of how to die well, this study explored what it is that middle-aged and older Koreans think of as "dying well." Specifically, it was aimed at classifying the perceptions people middle-aged and older have regarding dying well. To this end, we used data from the National Survey on Well-Dying, which was conducted in 2018 by the Korea Institute for Health and Social Affairs, and employed Latent Class Analysis. The demographic characteristics of each of the classified subgroups were identified through technical statistics. The types identified were multilayered depending on the imminence of death, perspectives of the last stages before dying, and the meaning of death in the context of social relationships. These types differed according to gender and subjective health conditions. Based on our findings in this study, we put forward policy suggestions about awareness improvement of personal and social levels, promoting on comprehensive death preparation, providing a system to reduce the cost of medical and nursing expense at the end of one's life, promoting of the right to self-determination regarding death, raising social attention to groups that are least prepared for dying well.

• Journal of the Korean Society of Radiology
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• v.17 no.7
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• pp.1099-1108
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• 2023

The mortise view radiography procedure is an ankle joint examination and observes the presence of trauma, sprain, or dislocation suspected in the ankle joint. The auxiliary equipment used during the mortise view radiography procedure can generate artifacts in the radiograph images and is not diverse enough to be custom-made for each patient; not cost-efficient. The purpose of this study is to create a custom assistive device to support mortise view radiography procedure. This study utilized 3D printing technology to create the mortise view radiography procedure assistive device (ShinHan Device; SHD). The lengths of the tibiotalar joint (TTJ), talar calcaneal joint (TCJ), and medial joint (MJ) were measured and evaluated by five researchers using both SHD and the prototype Hologic tool. The mean ranges were found to be 39.42-39.47 mm for TTJ, 31.41-31.57 mm for TCJ, and 21.21-21.23 mm for MJ while using SHD device. On the other hand, the measurements showed mean ranges of 39.73-39.79 mm for TTJ, 31.46-31.50 mm for TCJ, and 21.31-21.35 mm for MJ while using the Hologic tool. Based on this study results, the error ranges at all positions decreased by 24% for TTJ, 17% for TCJ, and 36% for MJ when using SHD device compared to the Hologic tool. Moreover, when SHD was used, it allowed for a highly reproducible examination posture (ICC = 0.99), and it enabled the acquisition of radiograph images without artifacts, which were present in the Hologic tool.

• Korean Chemical Engineering Research
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• v.62 no.3
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• pp.274-280
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• 2024

Machine learning techniques utilizing neural networks have been employed in various fields such as disease gene discovery and diagnosis, drug development, and prediction of drug-induced liver injury. Disease features can be investigated by molecular information of DNA. In this study, we developed a neural network to predict the length of DNA and the number of DNA species in mixture solution which are representative molecular information of DNA. In order to address the time-consuming limitations of gel electrophoresis as conventional analysis, we analyzed the dynamic data of a microfluidic concentrating device. The dynamic data were reconstructed into a spatiotemporal map, which reduced the computational cost required for training and prediction. We employed a convolutional neural network to enhance the accuracy to analyze the spatiotemporal map. As a result, we successfully performed single DNA length prediction as single-variable regression, simultaneous prediction of multiple DNA lengths as multivariable regression, and prediction of the number of DNA species in mixture as binary classification. Additionally, based on the composition of training data, we proposed a solution to resolve the problem of prediction bias. By utilizing this study, it would be effectively performed that medical diagnosis using optical measurement such as liquid biopsy of cell-free DNA, cancer diagnosis, etc.

• International Journal of Heart Failure
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• v.6 no.2
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• pp.56-69
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• 2024

Background and Objectives: The number of people with heart failure (HF) is increasing worldwide, and the social burden is increasing as HF has high mortality and morbidity. We aimed to provide updated trends on the epidemiology of HF in Korea to shape future social measures against HF. Methods: We used the National Health Information Database of the National Health Insurance Service to determine the prevalence, incidence, hospitalization rate, mortality rate, comorbidities, in-hospital mortality, and healthcare cost of patients with HF from 2002 to 2020 in Korea. Results: The prevalence of HF in the total Korean population rose from 0.77% in 2002 to 2.58% (1,326,886 people) in 2020. Although the age-standardized incidence of HF decreased over the past 18 years, the age-standardized prevalence increased. In 2020, the hospitalization rate for any cause in patients with HF was 1,166 per 100,000 persons, with a steady increase from 2002. In 2002, the HF mortality was 3.0 per 100,000 persons, which rose to 15.6 per 100,000 persons in 2020. While hospitalization rates and in-hospital mortality for patients with HF increased, the mortality rate for patients with HF did not (5.8% in 2020), and the one-year survival rate from the first diagnosis of HF improved. The total healthcare costs for patients with HF were approximately $2.4 billion in 2020, a 16-fold increase over the $0.15 billion in 2002. Conclusions: The study's results underscore the growing socioeconomic burden of HF in Korea, driven by an aging population and increasing HF prevalence.

• Progress in Medical Physics
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• v.25 no.3
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• pp.143-150
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• 2014

In general radiotherapy, mega-voltage (MV) x-ray images are widely used as the unique method to verify radio-therapeutic fields. But, the image quality of MV images is much lower than that of kilo-voltage x-ray images due to scatter interactions. Since 1990s, studies for the scatter correction have performed with digital-based MV imaging systems. In this study, a novel method for the scatter correction is suggested using scatter to primary ratio (SPR), instead of conventional methods such as digital image processing or scatter kernel calculations. We measured two MV images with and without a solid water phantom describing a patient body with given imaging conditions, and calculated un-attenuated ratios. Then, we obtained SPR distributions for the scatter correction. For experimental validation, a line-pair (LP) phantom using several Al bars and a clinical pelvis MV image was used. As the result, scatter signals of the LP phantom image were successfully reduced so that original density distribution of the phantom was restored. Moreover, image contrast values increased after SPR correction at all ROIs of the clinical image. The mean value of increases was 48%. The SPR correction method suggested in this study has high reliability because it is based on actually measured data. Also, this method can be easily adopted in clinics without additional cost. We expected that the SPR correction can be an effective method to improve the quality of MV image guided radiotherapy.