Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.
Objectives: The purpose of this study was to evaluate the relationship of nonalcoholic fatty liver and cardiovascular risk factors. Methods: This study was conducted to investigate the association of nonalcoholic fatty liver and cardiovascular risk factors for adult men (n=2976) and women (n=2442) who were over 19 years old, after excluding the HBsAg(+) or anti-HCV(+) patients and the men and women with increased alcohol intake (men: 40g/week, women: 20g/week). Results: Compared with the normal liver subjects, the nonalcoholic fatty liver subjects showed a significantly increased frequency of abnormal systolic blood pressure (${geq}120mmHg$), fasting blood sugar (${\geq}100mg/dL$), total cholesterol ($({\geq}200 mg/dL$), triglyceride ($({\geq}150mg/dL$), high density lipoprotein cholesterol (<40 mg/dL), low density lipoprotein cholesterol ($({\geq}130g\; m/dL$) and abdominal obesity in men, and all these measures were significantly increased in the women except for abnormal HDL cholesterol. After adjusting for the body mass index, age, smoking, exercise and a nonalcoholic liver, the odds ratios of an abnormal waist hip ratio were 1.35(95% Confidence Interval=1.05-4.72) in the mild fatty liver, 1.61 (1.19-2.18) in the moderate fatty liver, 2.77(1.57-4.92) in the severe fatty liver compared with a normal liver. The adjusted odds ratios for abnormal fasting blood sugar were 1.26(1.03-1.53) in the mild fatty liver, 1.62(1.27-2.06) in the moderate fatty Iiver and 1.77(1.12-2.78) in the severe fatty liver. The adjusted odds ratios for abnormal triglyceride were 1.38(1.11-1.72) in the mild fatty liver, 1.73(0.33-2.24) in the moderate fatty liver and 1.91 (1.17-3.10) in the severe fatty liver of men. Adjusted odds ratios for abnormal triglyceride were 1.50(1.04-2.15) in mild, 1.71(1.07-2.68) in moderate, 1.81(0.69-4.38) in severe fatty liver of women. Conclusions: The nonalcoholic fatty liver subjects had more cardiovascular risk factors compared with the normal liver subjects. Thus, prevention and treatment of the nonalcoholic fatty liver is necessary by lifestyle modifications such as restriction of alcohol intake, no smoking, exercise and adequate eating habits.
There is some evidence that soy isoflavone has beneficial effects on the concentration of blood lipids. In this study, we investigated habitual isoflavone intake levels and the relation among dietary isoflavone intake, blood pressure, and blood lipids of adult men (n = 149) and women (n = 205). Anthropometric measurements including blood pressure, dietary in-take assessment using 24-hour recall method, and biochemical assessment using blood were conducted. The average age, height, weight, and BMI were 54.7 years, 168.5 cm, 67.3 kg, and 24.5 $kg/m^2$ for men and 53.9 years, 153.8 cm, 59.2 kg, and 25.0 $kg/m^2$ for women, respectively. The mean daily intakes of total food and energy were 1219.1 g and 1740.9 kcal for men and 1071.3 g and 1432.6 kcal for women, respectively. The mean daily isoflavones (daidzein + genistein) intake of men and women were 20.0 mg and 14.2 mg, respectively. Blood pressure of the subjects was 128.3/75.5 mmHg for men and 124.1/73.7 mmHg for women. Serum lipids of men and women were 180.2 and 184.9 mg/dL for total cholesterol, 160.8 and 137.6 mg/dL for triglyceride, 41.5 and 44.7 mg/dL for HDL-cholesterol, 106.6 and 112.7 mg/dL for LDL-cholesterol, and 3.5 and 3.3 for atherogenic index, respectively. Serum triglyceride and atherogenic index of men were significantly higher than those of women. In men, isoflavone intake and the level of total serum cholesterol were negatively (p < 0.05) correlated, after adjusted age. In women, there were significant correlations between isoflavone intake and blood pressure (systolic and diastolic), after adjusted age (p < 0.05). Based on these results, we concluded that higher isoflavone intake seemed to be related to a better lipid profile in men and lower blood pressure in women. But more epidemiological studies and controlled clinical trials would help to confirm the optimal amount required for the prevention and treatment of cardiovascular disease.
Objectives: The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India. Methods: The present study used data from 139 679 HIV patients aged ${\geq}15$ years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival. Results: The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for < $100cells/mm^3$ vs. > $350cells/mm^3$), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients. Conclusions: The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.
Seo, Hyun-Ju;Kim, Chong-Soon;Chang, Yun-Kyun;Park, Il-Geun;Kim, Soo-Geun
Journal of Preventive Medicine and Public Health
/
v.39
no.3
/
pp.229-234
/
2006
Objectives: Cardiovascular disease is one of the main causes of death and morbidity in Korea. In this study, the prevalence and incidence of developing hypertension in a male-workers' cohort were investigated during 3-years follow-up with a view to find the risk factors that affected the development of hypertension. Methods: Among the 5,374 people who participated in a routine health check up, 3,852 people with normal blood pressure and who had no history of hypertension were prospectively followed up for 3 years. The classification of hypertension was based on the JNC7 report (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). Life style factors and underlying diseases that were related to the risk factors of hypertension were collected by using a self-report questionnaires via the internet. Results: The prevalence of hypertension was 28.3% (1,520/5,374) at the first screening (2001). It was found that the incidence in 2004 of hypertension for the follow-up subjects (3,711) who had normal blood pressure in 2001 was 7.6 per 100 person-year. Multiple logistic regression analysis of the variables related to the risk factors of hypertension was carried out. The relative risks were 1.037 (95% CI=1.022-1.053) as the age increased 1 year and 1.039 (95% CI=1.023-1.055) as the body mass index increased $1kg/m^2$. The relative risk for the prehypertensive group was 2.501 (95% CI=1.986-3.149) compared to the normotensive group. These results showed that age, body mass index and the baseline blood pressure were significantly related to the incidence of hypertension. Conclusions: The incidence of hypertension was 7.6 per 100 person-year during follow-up. It was concluded that the risk factors for developing hypertension in the short-term were age, BMI, and prehypertension; Especially, this showed that it is necessary for prehypertensives to manage their body weight and blood pressure to prevent hypertension in middle-age by modifying their life style.
'Medicinal water' have been used for the treatment of disease and the promotion of health. To study the quality and health effect of 'medicinal water', the eleven springs located near Taegu City during the period of March 27-February 17, 1986 were tested for biological and physiochemical examination and were checked for sanitary environment around the spring. Among them three springs (27.3%) had a good sanitary equipments and only one was negative for biological examination. Three 'medicinal warer' were accepted as potable by physicochemical examination. According to above findings, all of the 'medicinal water' sampled from the springs located near Taegu City were not potable by this sanitary survey adopted Drinking Water Standard in Korea. Kachang and Youngchum 'medicinal water' were more contaminated by heavy metals and bacteria than those of other springs. To solve the problem of contamination by heavy metals that originated from uncertain sources, we should search for the sources of water contamination, remove it completely and also support the environmental equipments and management system in protection of safe 'medicinal water' supply.
Kim, Chang-Su;Lee, Han-Na;Kim, Hyo-Jin;Seo, Sang-Young;Jo, Jong-Hyun;Lee, Eun-Suk;Ahn, Min Sil;Kim, Hee-Jun
Korean Journal of Organic Agriculture
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v.29
no.4
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pp.561-574
/
2021
This study was conducted to evaluate the control efficacy of the organic farming materials (OFMs) on tuber rot of Gastrodia elata caused by Fusarium spp. The antifungal activities in vitro as well as the suppressive effect of 15 OFMs on the spore germination and germ tube growth by inoculating spore suspension on immature tubers in vivo were investigated. 7 OFMs inhibited the mycelial growth of Fusarium spp. and 7 of them were microbial agents. In the screening using immature tubers, 3 OFMs were very effective with control efficacy value of 70%. Among them, sulfur provided suppressive effect on both mycelial growth and spore germination against tuber rot of G. elata. Finally, 3 OFMs were selected to test the protective and curative effects, and all chosen OFMs significantly suppressed disease incidence when applied in the preventive action, in comparison with the curative action. Especially, sulfur and Bacillus subtilis gave excellent protective control efficacy with control values of 93.2% and 86.9%, respectively, whereas its curative control effect was relatively low (73.3%, 60.2%). On the other hand, the preventive and curative effects of citronella + paraffin oil + ethyl alcohol were 73.3% and 67.0%, respectively. This study suggests that tuber rot of G. elata can be controlled by some OFMs in the rain shelter greenhouse under continuous cultivation condition and protective treatment is more important and efficient.
In order to investigate the effect of circulating blood and extinguishing blood stasis method on acute ischemic stroke treatment, we compared muscle weakness in two groups. Dansamhwanotang was administered to experimental group and the Sopungtang was administered to comparison group. In prospective and consecutive study, 24 patients(male 14, female 10) were admitted to hospital within 6hours(median $4.21{\pm}2.45)$ after stroke attack. All of them were diagnosed computed tomography as acute cerebral infarction. We divided that patients into two groups. The experimental group was 13, took median $4.17{\pm}1.72hrs$ to admission after stroke attack and the comparison group 11, median $4.31{\pm}2.72hrs$ to admission after stroke attack. There was no statistical difference in time consumed from stroke onset to admission(P>0.05). Muscle weakness was measured on admission and 7 days later on AMA(American Medical Association) method. In the experimental group, muscle weakness on admission was $2.23{\pm}0.51$ and $2.79{\pm}0.72$ in upper and lower extremity, respectively. In comparison group, muscle weakness on admission was $2.17{\pm}0.43$ and $2.67{\pm}0.82$ in upper and lower extremity, respectively. There was no difference in muscle weakness(P〈0.05). In 7 days after, muscle weakness was $2.31{\pm}0.35$ in upper extremity and $3.15{\pm}0.12$ in lower extremity in experimental group, and $2.27{\pm}0.74$ in upper extremity and $3.45{\pm}0.48$, lower extremity in comparison group. There was no meaningful improvement statistically in upper extremity(p<0.05) but significant evolution in lower extremity(p<0.05). The muscle weakness comparison between admission time and 7 days later was as follows. Experimental group had improvement at the degree of $0.24{\pm}0.92$, $0.42{\pm}0.82$ in upper and lower extremity, respectively and comparison group, $0.12{\pm}0.82$, $0.27{\pm}0.97$ in same part(p<0.05). So, Dansamhwanotang administered group had more good muscle weakness improvement than Sopungtang administered group(P>0.05). From the above result, I suppose that circulating blood and extinguishing blood stasis method helps recover hemiparesis caused by acute ischemic cerabral disease, in acute stage at least.
Park, Dong Il;Kim, Sun Young;Kim, Ju Ock;Jung, Sung Soo;Park, Hee Sun;Moon, Jae Young;Chung, Chae Uk;Kim, Song Soo;Seo, Jae Hee;Lee, Jeong Eun
Tuberculosis and Respiratory Diseases
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v.78
no.4
/
pp.315-320
/
2015
Background: The efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy can be measured based on the rate of treatment response, based on the Response Evaluation Criteria in Solid Tumors (RECIST) criteria or progression-free survival (PFS). However, there are some patients harboring sensitive EGFR mutations who responded poorly to EGFR-TKI therapy. In addition, there is variability in the PFS after EGFR-TKI treatment. Methods: We performed a retrospective analysis of the medical records of 85 patients with non-small cell lung cancer, who had achieved a stable disease or better response at the first evaluation of treatment response, after receiving a 2-month course of gefitinib. We calculated the tumor shrinkage rate (TSR) by measuring the longest and perpendicular diameter of the main mass on computed tomography before, and 2 months after, gefitinib therapy. Results: There was a significant positive correlation between the TSR and PFS (R=0.373, p=0.010). In addition, a simple linear regression analysis showed that the TSR might be an indicator for the PFS ($B{\pm}standard$ error, $244.54{\pm}66.79$; p=0.001). On univariate analysis, the sex, histologic type, smoking history and the number of prior chemotherapy regimens, were significant prognostic factors. On multivariate regression analysis, both the TSR (${\beta}$=0.257, p=0.029) and adenocarcinoma (${\beta}$=0.323, p=0.005) were independent prognostic factors for PFS. Conclusion: Our results showed that the TSR might be an early prognostic indicator for PFS in patients receiving EGFRTKI therapy.
Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.
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