• The Journal of the Korea Contents Association
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• v.15 no.6
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• pp.290-296
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• 2015

The purpose of this study was to derive the proposals and to suggest the exposure dose reduction scheme on pediatric head CT scan by analyzing and comparing CT dose index (CTDI) and the national diagnostic reference levels. From January 2014 to December, 231 children under 10years who were requested a pediatric head CT scan with head injury were examined. Research methods were to research and analyze the general characteristics kVp, mA test coverage $CTDI_{vol}$ and DLP referring to dose reports and electronic medical record (EMR). As a result, 7.4%(17 patients) of the total subjects in $CTDI_{vol}$ showed a national diagnostic reference levels exceeding. For DLP 41.6%(96 patients) in excess was relatively higher than $CTDI_{vol}$. DLP was exceeded more than about 60% that is higher than the CT dose index presented by Korea Food & Drug Administration. it is cause of high DLP that scan range increased more than about 30% wider than the standard test coverage presented in Health Insurance Review & Assessment Service. In conclusion, it is able to significantly lower the dose if it is complied with checking the baseline scan range of pediatric head CT scan and appropriately adjusting the protocol.

• Journal of the Korean association of regional geographers
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• v.16 no.6
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• pp.706-723
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• 2010

The impervious surface was frequently employed as a proxy of the total environmental burden in the urban area. The impervious surface was extracted from a satellite image and the GIS (Geographical Information System) database for childhood asthma hospitalizations was generated for a total of 62,136 children using the National Health Insurance database of South Korea. Children living in an impervious environment do result in almost twice as many hospitalizations (26.58%) for asthma, as compared to the sub-urban pervious living (15.82%). Furthermore, the risk zones with persistently high hospitalizations for three years were specifically identified over the impervious sub-district alone. The impervious zone showed a small inter-year variation of hospitalizations (r: 0.937) while the sub-urban pervious fringe was found to display a yearly variation(r: 0.371). The strong temporal autocorrelation means that the impervious areas have frequent long-lived hospitalizations for asthma, thus children living in impervious areas were likely to have had more chronic asthma attacks than those living in pervious areas. These experimental results indicate that an impervious surface as thematic parameter of analysis is a crucial explanatory variable for asthma hospitalizations and its longer persistence among children.

• Journal of Radiation Protection and Research
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• v.30 no.4
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• pp.185-196
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• 2005

Although medical exposure from diagnostic radiology procedures such as conventional x-rays, CT and PET scans is necessary for healthcare purposes, understanding its characteristics and size of the resulting radiation dose to patients is much of worth because medical radiation constitutes the largest artificial source of exposure and the medical exposure is in a trend of fast increasing particularly in the developed society. Annual collective doses and per-caput effective doses from different radiology procedures in Korea were estimated by combining the effective dose estimates per single medical procedure and the health insurance statistics in 2002. Values of the effective dose per single procedure were compiled from different sources including NRPB reports, ICRP 80, MIRDOSE3.1 code and independent computations of the authors. The annual collective dose reaches 27440 man-Sv (diagnostic radiology: 22880 man-Sv, nuclear medicine: 4560 man-Sv) which is reduced to the annual per-caput effective dose of 0.58 mSv by dividing by the national population of 47.7 millions. The collective dose is far larger than that of occupational exposures, in the country operated 16 nuclear power plants in 2002, which is no more than 70 man-Sv in the same year. It is particularly noted that the collective dose due to CT scans amounts 9960 man-Sv. These results implies that the national policy for radiation protection should pay much more attention to optimization of patient doses in medicine.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.502-518
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• 2019

Objective : Since less invasive endovascular treatment was introduced to South Korea in 1994, a considerable proportion of endovascular treatments have been performed by neuroradiology doctors, and endovascular treatments by vascular neurosurgeons have recently increased. However, few specific statistics are known regarding how many endovascular treatments are performed by neurosurgeons. Thus, authors compared endovascular treatments collaboratively performed by vascular neurosurgeons with all cases throughout South Korea from 2013 to 2017 to elucidate the role of neurosurgeons in the field of endovascular treatment in South Korea. Methods : The Society of Korean Endovascular Neurosurgeons (SKEN) has issued annual reports every year since 2014. These reports cover statistics on endovascular treatments collaboratively or individually performed by SKEN members from 2013 to 2017. The data was requested and collected from vascular neurosurgeons in various hospitals. The study involved 77 hospitals in its first year, and 100 in its last. National statistics on endovascular treatment from all over South Korea were obtained from the Healthcare Bigdata Hub website of the Health Insurance Review & Assessment Service based on the Electronic Data Interchange (EDI) codes (in the case of intra-arterial (IA) thrombolysis, however, statistics were based on a combination of the EDI and I63 codes, a cerebral infarction disease code) from 2013 to 2017. These two data sets were directly compared and the ratios were obtained. Results : Regionally, during the entire study period, endovascular treatments by SKEN members were most common in Gyeonggido, followed by Seoul and Busan. Among the endovascular treatments, conventional cerebral angiography was the most common, followed by cerebral aneurysmal coiling, endovascular treatments for ischemic stroke, and finally endovascular treatments for vascular malformation and tumor embolization. The number of endovascular treatments performed by SKEN members increased every year. Conclusion : The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN.

• Journal of Convergence for Information Technology
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• v.9 no.6
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• pp.194-201
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• 2019

This cohort study aimed to identify the effects of daily PM10 exposure on the hospital admission of patients with respiratory diseases, during the nine-year period (2002-2010), in Seoul, Korea. The research subjects were 13,974 patients who had been hospitalized with respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia. During the follow-up period, an increase of 10 ug/m3 in PM10 under the threshold of 50 ug/m3 of PM10 led to hospital admission in 1.38% of the age group younger than 15 years, 1.62% in those 65 years or older, 2.87% in patients 75 years or older and in 1.50% of pneumonia patients, 1.51% of COPD patients, and 1.55% of pneumonia and asthma patients. Under the threshold of 80 ug/m3 of PM10, there was a 3.71% increase in new patients admitted in the age group 65 years or older and 4.25% in those at least 75 years old. Our study found that high PM10 was associated with increased risk of admission of respiratory patients, especially in the elderly. People who already have a respiratory disease should refrain from exposure to particulate matter when there is a high concentration of PM10, especially older patients.

• Parasites, Hosts and Diseases
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• v.60 no.1
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• pp.39-43
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• 2022

Plasmodium vivax exhibits dormant liver-stage parasites, called hypnozoites, which can cause relapse of malaria. The only drug currently used for eliminating hypnozoites is primaquine. The antimalarial properties of primaquine are dependent on the production of oxidized metabolites by the cytochrome P450 isoenzyme 2D6 (CYP2D6). Reduced primaquine metabolism may be related to P. vivax relapses. We describe a case of 4 episodes of recurrence of vivax malaria in a patient with decreased CYP2D6 function. The patient was 52-year-old male with body weight of 52 kg. He received total gastrectomy and splenectomy 7 months before the first episode and was under chemotherapy for the gastric cancer. The first episode occurred in March 2019 and each episode had intervals of 34, 41, and 97 days, respectively. At the first and second episodes, primaquine was administered as 15 mg for 14 days. The primaquine dose was increased with 30 mg for 14 days at the third and fourth episodes. Seven gene sequences of P. vivax were analyzed and revealed totally identical for all the 4 samples. The CYP2D6 genotype was analyzed and intermediate metabolizer phenotype with decreased function was identified.

• Neonatal Medicine
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• v.16 no.2
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• pp.213-220
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• 2009

Purpose: Hearing loss is one of the common birth defects in humans, with a reported prevalence of 1-3 per 1000 newborns. We investigated the incidence of hearing loss and evaluated the use of neonatal hearing screening test in neonatal intensive care unit (NICU) graduates who are at greater risk for hearing loss than normal newborns. Methods: The neonates admitted to the NICU of Asan Medical Center from 1 March, 2003 to 30 March, 2008 who were available for follow-up were included. Those who failed the first auditory brainstem response prior to discharge were retested with the stapedial reflex test, auditory brainstem response and tympanometry in the Otolaryngology department. Results: Of 2,137 neonates, 2,000 (93.5%) neonates were tested prior to discharge. Sixty-seven neonates (3.4%) failed the first newborn hearing screening test. Of 67 infants, 52 infants were retested for a second hearing test. Excluding 10 infants (19.2%) who were lost during follow-up, 16 infants were confirmed to have hearing impairment of which 12 and 4 infants had unilateral and bilateral hearing loss, respectively. Of 16 infants, 5 did not meet the criteria set by the Korean National Health Insurance Corporation. Conclusion: The prevalence of hearing impairment in NICU graduates is about 0.8%, excluding those who were lost for follow up, necessitating a systemic and effective hearing assessment program among these high risk infants and more generous national insurance coverage.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.557-566
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• 2009

Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.161-202
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• 2024

Backgrounds/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions: The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

• Journal of agricultural medicine and community health
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• v.30 no.1
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• pp.1-14
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• 2005

Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.