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Lymphocyte Proportion and Cytokines from the Bone Marrow of Patients with Far-Advanced Pulmonary Tuberculosis with Peripheral Lymphocytopenia (말초혈액의 림프구감소증을 동반한 중증폐결핵 환자들에서 골수 내의 림프구 분획과 사이토카인 소견)

  • An, Chang Hyeok;Kyung, Sun Yong;Lim, Young Hee;Park, Gye Young;Park, Jung Woong;Jeong, Sung Hwan;Ahn, Jeong Yeal
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.449-458
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    • 2003
  • Background : The poor prognostic factors of far-advanced pulmonary tuberculosis(FAPTB) are lymphocytopenia in the peripheral blood(PB)(< $1,000/mm^3$) and $T_4$-cell count ${\leq}500/mm^3$. However, the cause of PB lymphocytopenia in FAPTB is unclear. The aim of this study was to analyze the lymphocyte proportion and cytokines of the bone marrow(BM) in FAPTB patients with peripheral lymphocytopenia in order to clarify whether the limiting step of the lymphocytopenia occurs in production, differentiation, or circulation. Methods : This study included patients with FAPTB between August 1999 and August 2002 who visited Gachon Medical School Gil Medical Center. The exclusion criteria were old age(${\geq}65years$), cachexia or a low body weight, shock, hematologic diseases, or BM involvement of tuberculosis. The distributions of cells in PB and BM were analyzed and compared to the control group. The interleukin(IL)-2, IL-7, IL-10, TNF-${\alpha}$, Interferon-${\gamma}$, and TGF-${\beta}$ levels in the BM were measured by ELISA. Result : Thirteen patients(male : female=9:4) were included and the mean age was $42{\pm}12$years. The proportion and count of the lymphocytes in the PB were significantly lower in the FAPTB group ($7.4{\pm}3.0%$, $694{\pm}255/mm^3$ vs. $17.5{\pm}5.8%$, $1,377{\pm}436/mm^3$, each p=0.0001 and 0.002). The proportion of immature lymphocyte in the BM showed a decreasing trend in the FAPTB group($9{\pm}4%$ vs. $12{\pm}3%$, p=0.138). The IL-2($26.0{\pm}29.1$ vs. $112.2{\pm}42.4pg/mL$, p=0.001) and IL-10($3.4{\pm}4.7$ vs. $12.0{\pm}8.0pg/mL$, p=0.031) levels in the BM were significantly lower in the FAPTB group than those in control. The levels of the other cytokines in FAPTB group and control were similar. Conclusion : These results suggest that the cause of lymphocytopenia in PB is associated with a abnormality IL-2 and IL-10 production in the BM. More study will be needed to define the mechanism of a decreased reservoir in BM.

Diagnostic Accuracy of $^{99m}Tc$-DISIDA Scintigraphy in Biliary Atresia (선천성 담도폐쇄증에서 $^{99m}Tc$ DISIDA 신티그라피의 진단정확성)

  • Hyun, In-Young;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Chung, June-Key;Suh, Jung-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.357-363
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    • 1994
  • We evaluated the diagnostic accuracy of $^{99m}Tc$-DISIDA scintigrauhy as a mean of differentiating biliary atresia from neonatal hepatitis. $^{99m}Tc$-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepatic retention Index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake Index was graded visually with 5 minute images using the following scoring scheme : grade 0(normal hepatic uptake), grade 1(decreased hepatic uptake), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent intestinal radioactivity. The results were as follows ; 1) None of the 30 biliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity. The sensitivity, specificity, and accuracy of the presence of intestinal radioactivity ?or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patients with absent intestinal radioactivity the mean hepatic retention index was $1.5{\pm}0.6$ in the 16 biliary atresia patients, and $1.1{\pm}0.2$ in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary atresia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake Index between biliary atresia and neonatal hepatitis patients. However there were differences in age, total bilirubin, and hepatic uptake index between neonatal hepatitis patients with and without intestinal radioactivity. The hepatic uptake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioactivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake Index and the hepatic retention index. Thus, we conclude that $^{99m}Tc$-DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patient's age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.

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Association of Health-related Behaviors with Socio-demographic Characteristics (건강증진과 관련된 행태에 영향을 미치는 인구사회학적 특성)

  • Roh, Won-Hwan;Kim, Seok-Beom Gib;Kang, Pock-Soo
    • Journal of agricultural medicine and community health
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    • v.23 no.2
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    • pp.157-174
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    • 1998
  • A survey was conducted to study the influence of socia-demographic factors on health-related behaviors. from June 1 to July 31, 1996. The study population was 1,903 adults in Kyongju City. A questionnaire method was used to collect data. Health-related behaviors included 24 items for men and 26 items for women. The followings are summaries of findings : The compliance of health promotion activities was higher when the age was older in men, when married, when having no religion and when the education level was higher than the other groups. And it was significantly higher when the income was lower in men and higher in women, in the residents living in apartment, in white collar workers, in the chronic ill people and when the body weight was lower than the other groups. Notable differences were found in the composition of health behavior factors for socio-demographic characteristics. Men used more tobacco, coffee and tea, salt and alcohol than women. However, the practice rates of regular exercise and physical examination were higher in men than women. On the other hand, the practice rates of fruit/vegetable intake, milk drinking and regular tooth brushing were higher in women than men. When the age was old, the amount of fruit/vegetable intake, the frequency of physician visit and health check-up, and regularity of meal were increased. When the income was high, the use rate of seat-belts, the amount of coffee, milk, fruit/vegetable and red meat intake were increased. The frequency of regular exercise. tooth brushing, health check-up, pap test and breast self examination were higher in the rich than the poor. When the education level was high, the frequency of regular exercise and tooth brushing, and the use rate of seat belts were increased, and the amount of alcohol consumption and salt intake were decreased. These findings suggest that socio-demographic factors are significantly associated with the patterns of health behaviors. In conclusion public health programs and individual counseling efforts should be multifaceted and behavior-specific to encourage to practice healthy life-style.

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Yesterday and Today of Twelve Excellent Sceneries at Banbyeoncheon Expressed in Heojoo's Sansuyucheop (허주(虛舟) 산수유첩(山水遺帖)에 표현된 반변천(半邊川) 십이승경(十二勝景)의 어제와 오늘)

  • Kim, Jeong-Moon;Rho, Jae-Hyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.90-102
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    • 2012
  • Sansuyucheop by Heojoobugun(虛舟府君) as the subject of this study is a 십이-width picture album by the eldest grandson of 11 generations for Goseong Lee family, Lee Jong Ak(李宗岳: 1726-1773), a figure having five habits(五癖) for ancient documents(古書癖), playing the gayageum(彈琴癖), flowering plant(花卉癖), paintings and calligraphic works(書畵癖) and boating(舟遊癖) etc., who boated with 18 relatives, and those by marriage from old home, home of mother's side, wife's home, and his home for 5 days Apr. 4 through 8, 1763, starting from Imcheonggak, through Yangjeong(羊汀), Chiltan(七灘), Sabin Auditorium(泗濱書院), Seonchang(船倉), Nakyeon(落淵), Seonchal(仙刹), Seonyujeong(仙遊亭), Mongseongak(夢仙閣), Baekwoonjeong(白雲亭) and Naeap Village(川前里), Iho(伊湖), Seoeodae(鮮魚帶) to the returning point, Bangujeong(伴鷗亭), cruised magnificent views around Banbyeoncheon called 'Andong 8 Gyeong' or 'Imhagugok', and whenever the boat anchored, appreciated the scenery at each point, and enjoyed and loved arts playing the geomungo. This study reached following findings through grasping physical, ecological, visual and aesthetic changes about the places, sceneries, plant elements and past and current scenery of the width pictures expressed at this Sansuyucheop. The refinement on the boat seeing the clear river water, white sand beach, fantastically-shaped cliffs expressed at this Sansuyucheop, exchanging poems and calligraphies, and enjoying the geomungo is a good example displaying the play culture of high-class in Joseon Dynasty. Also construction of Imha Dam and Andong Dam has caused serious visual and ecological changes, making us not enable to feel the original mood of the background spots such as Yangjeonggwabeom(羊汀過帆), Chiltanhuseon(七灘候船), Sasubeomjoo(泗水泛舟), Seonchanggyeram(船倉繫纜), Nakyeonmosaek(落淵莫色), Mangcheonguido(輞川歸棹), Ihojeongdo(伊湖停棹), but only discern then landscape or sentiment through the landscape described at the canvas. The 1st picture(Donghohaeram, 東湖解纜), and the 11th picture(Seoeobanjo, 鮮魚返照) of Heojoobugun's Sansuyucheop expressed trees thought to be fallen, brad-leaf tall trees, and the 9th picture(Unjeongpungbeom, 雲亭風帆) formed a pine forest called 'Gaeho(開湖)' by Uncheongong planting 1,000 pine trees with the village people in 1617. In addition, Seunggyeongdo expressed ever-green needle leaf trees at the natural topography, and fallen-leaf tall trees around the pavilion and building. Comparative consideration of Heojoobugun's Sansuyucheop and Shinam's Dongyusipsogi(東遊十小記) showed that the location of Samgok is assumed to be Macheon and Chiltan, so Imhagugok is assumed to start from Baekunjeong of Ilgok, Igok from Imcheon and Imcheon auditorium, Samgok from Mangcheon and Chiltan, Sagok from Sabin Auditorium of Sasoo, Ogok from Songseok, Yukgok from Sooseok of Seonchang, Chilgok from Nakyeonhyeonryu, Palgok from Seonchalsa and Seonyoojeong, and Gugok from Pyong Yuheo. This study can be significant in that it could clarify that Heojoobugun's Sansuyucheop is judged to be valuable in exquisitively expressing the coast of Banbyeon River, the biggest branch stream in the Nakdong River at the latter half of Joseon Dynasty, and as a vital diagrammatical historical data to make a comparative analysis of currently rarely-seen ancestors' life traces and landscape factors with present ones.

Relation between Health Status and Intake of Soy Isoflavone among Adult Women in Seoul (서울 거주 성인 여성의 대두 이소플라본 섭취와 건강과의 관련성)

  • Lee, Min-June;Sohn, Chun-Young;Park, Ok-Jin
    • Journal of the East Asian Society of Dietary Life
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    • v.20 no.2
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    • pp.218-230
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    • 2010
  • This study was conducted to survey isoflavone intake among adult women in menopause with diseases such as metabolic syndrome and osteoporosis and to analyze the relationship between each of these chronic diseases followed by isoflavone intake and the related health risk index. The average age of the subjects was 49.97 years old, while that of the pre-menopausal subjects was 45.14 years, and the post-menopausal subjects was 55.99 years. The average body mass index (BMI), waist-hip circumference, body fat percentage, blood pressure, blood sugar and blood lipid content of the post-menopausal subjects were higher in significant difference than those of the pre-menopausal subjects. The bone density of the hip and spine in post-menopausal subjects was lower in significant difference than that of the pre-menopausal subjects. After menopause, the subjects had a lower ratio of individuals at risk of anemia when compared with the subjects before menopause, but had higher health risk ratio related to each type of chronic disease, including obesity, hypertension, high cholesterol and osteoporosis than the subjects before menopause. The intake frequency of each soybean food was similar among subjects before/after menopause. The most common soybean based foods consumed by the subjects were soybean, soybean curd and soybean paste. The average daily intake level of isoflavone among subjects before menopause was 25.48 mg, while that of subjects after menopause was 32.25 mg. Evaluation of the distribution of the isoflavone level revealed that the pre-menopausal subjects consumed 3.29~78.36 mg and the post-menopausal subjects consumed 3.18~116.59 mg. The intake level by each individual varied greatly. The pre-menopausal subjects had a low BMI index and systolic blood pressure as much as their isoflavone intake level was high. Additionally, the post-menopausal subjects had a low menarche age and high menopause age when their isoflavone intake level was high, the BMI index and waist-hip circumference ratio was highest among individuals with lowest isoflavone intake level. This study showed that there was a possible relationship between soybean isoflavone intake and health problems such as obesity, high cholesterol, and osteoporosis in women after menopause with diseases such as metabolic syndrome and osteoporosis, even if this relationship was not great.

Studies on the Shade Tolerance, Light Requirement, and Water Relations of Economic Tree Species(III) - Analysis of Pressure-Volume Curves on the Changes of Tissue Water Relations of Five Deciduous Hardwood Species Subjected to Artificial Shading Treatments - (주요경제수종(主要經濟樹種)의 내음성(耐陰性) 및 광선요구도(光線要求度)와 수분특성(水分特性)에 관한 연구(III) - 인공피음처리하(人工被陰處理下)에서 자라는 활엽수(闊葉樹) 5수종(樹種)의 수분특성(水分特性) 변화(變化)에 대한 P-V곡선(曲線) 분석(分析) -)

  • Choi, Jeong Ho;Kwon, Ki Won
    • Journal of Korean Society of Forest Science
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    • v.90 no.4
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    • pp.524-534
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    • 2001
  • The pressure-volume curve parameters were investigated to elucidate the effects of shading treatment on the water relations of the one year old seedlings of Betula platyphylla var. japonica, Betula schmidtii, Zelkova serrata, Acer mono and Prunes sargentii subjected to five levels of artificial shading treatments. The osmotic potentials at full turgor(${\phi}_{{\pi}o}$) measured under full sunlight changed with species and growing season in the ranges of -1.04~-1.27MPa, -1.03~-1.48MPa, -0.94~-1.44MPa in first year treatment, and -0.90~-1.37MPa, -1.05~-1.79MPa, -0.99~-1.30MPa in second year treatment in June, July, and September, respectively. The osmotic potentials at full turgor increased with increment of shading level in the ranges of -0.90~-1.79MPa in full sunlight and -0.58~-1.23MPa in nearly full shading level(E) through the growing seasons in all the species studied. The osmotic potentials at turgor loss point(${\phi}_{{\pi}p}$) measured in full sunlight changed in the ranges of -1.64~-2.11MPa, -1.67~-2.15MPa, -1.47~-2.11MPa, and -1.45~-2.04MPa, -1.30~-2.00MPa, -1.28~-2.33MPa in June, July, and September of first and second years, respectively. Most of ${\phi}_{{\pi}p}$ measurements were lower within about 0.5MPa in comparison with those of ${\phi}_{{\pi}o}$. The measurements of ${\phi}_{{\pi}p}$ also increased with increment of shading level, and the differences in ${\phi}_{{\pi}p}$ among shading levels were generally greater than those in ${\phi}_{{\pi}o}$ by species and by growing season. Most of the osmotic potentials at turgor loss point as like as at full turgor were lowered in July than in June and September. The measurements of relative water content at turgor lass point(RWCp) in full sunlight were in the similar ranges of 81~88%, 71~86%, 75~84%, and 82~87, 72~84%, 76~86% in June, July, and September of first and second years, respectively. The RWCp were a little higher in A. mono and P. sargentii than in B. platyphylla var. japonica, B. schmidtii, and Z. serrata. The RWCp also decreased from 71~88% in full sunlight to 48~77% in nearly full shading treatment with increment of shading level. Even if there were some exceptions by species or by growing season, the shading effects on the changes in some P-V parameters were distinctly observed in the present study. The change in P-V parameters following shading treatment may be presumably inferred on the changes in solute accumulation, membrane elasticity, symplasmic water volume, and so on. But much more experiments should be necessarily continued for getting detailed informations on the physiological mechanism of shading effects relating to the changes in P-V parameters.

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The Studies on the Physiological Active Substances of Mugwort Components for the Utilization to the Foods of Animal Husbandry (축산식품에 이용하기 위한 쑥 성분중의 생리활성에 관한 연구)

  • Lee, Chi-Ho
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 1998.05a
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    • pp.37-54
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    • 1998
  • This study was conducted to investigate the effects of mugwort extracts on the blood ethanol concentration, liver function and low level of cadmuim(Cd) in rats. The effects of mugwort extracts on the blood ethanol concentration was studied in Sprague-Dawley rats (10 weeks old) administered p.o. with 25% ethanol (5g/1kg body weight) and then injected with mugwort extracts (at the 2% levels of daily feed consumption compared with the concentration of catechins level in mugwort extracts) in caudal vein. SD rats were divided into five groups : control group (CON-E, only ethanol and 0.85% saline sol'n treated instead of each extracts), water extracts of mugwort treated to the control (MDW-E), ethanol extracts of mugwort treated to the control (POH-E). And then rat plasma of each time (0hr, 1hr, 2hr, 3hr) was investigated ethanol concentration by gas chromatography. Another rats were measured at the time of 0 and 5hr for the test of GOD(Glutamic Oxaloacetic Transaminase) and GPT(Glutamic Pyruvic Transaminase). Components of each extracts were analyzed by using high performance liquid chromatography. The effects of mugwort extracts on the liver function were studied in culture of rat hepatocyte composed of three groups : Control group and two groups treated with each extracts (1% & 2% MDW, 1% & 2% MOH). Condition of rat hepatocytes cultured for 36hr at $37^{\circ}C$(5% $CO_2$ incubator), number of cells, GOT and GPT activity were investigated. The results obtained were summarized as follows ; 1. Catechins level of mugwort extracts was $8{\sim}10mg/100g(MDW)$, $3{\sim}4mg/100g(MOH)$ 2. The contents of (-)-Epigallocatechin was high in MDW 3. The effects of mugwort extracts on the blood ethanol concentration were as follows; 1) The order in ethanol degradation efficiency was MDW-E > MOH-E > CON-E. 2) Ethanol concentration significantly decreased (p<0.05) in MDW-E and MOH-E. 4. The effects of mugwort extracts on the liver function were as follows; (rat hepatocytes cultured for 36hr at $37^{\circ}C$) 1) Cells condition of MDW-L was better than other groups. 2) The order in number of cells (rat hepatocytes) was 2% MDW-L >1% MDW-L >1% MOH-L > Con-L > 2% MOH-L 5. Cd treatment increased concentrations of hepatic GSH level, and decreased GOT activity in plasma. Therefore, this results suggest that the effects of mugwort extracts may an important rols in degradation ethanol and recovery liver function in body. Also, Mugwort extracts may modify the toxicities of Cd in Cd-treated rats and play an important roles in preventing the liver from various toxicants including Cd in Cd treated rats.

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Studies on a Plan for Afforestation at Tong-ri Beach Resort(II) -Analyses of Crown Amounts and Soil Properties in the Disaster-damage Prevention Forests of Pinus thunbergii PARL., the Valuation on Soil Properties for Planting and Planning for Afforestation- (통리(桶里) 해수욕장(海水浴場) 녹지대(綠地帶) 조성(造成)에 관(關)한 연구(硏究)(II) -곰솔 해안방재림(海岸防災林)의 수관량(樹冠量) 및 토양분석(土壤分析), 식재기반평가(植栽基盤評價) 및 녹지대계획(綠地帶計劃)-)

  • Cho, Hi Doo
    • Journal of Korean Society of Forest Science
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    • v.77 no.3
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    • pp.303-314
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    • 1988
  • Tong-ri beach has not enough vegetation to be enjoyed by the sea bathers and to be satisfied with preventing the disaster-damages, but mixed forest near the beach can work its funtions and the old forest of Pirus thunbergii $P_{ARL}$. near the beach do a Little. Therefore it is very urgent to plant more trees near the beach for bathers and disaster-damage prevention. This study was carried out for planning an afforestation, with reporting upon the crown amounts and soil properties of disaster-damage prevention forests of P. thunbergii $P_{ARL}$. planted on the coast sand dunes in 1970 and 1976, and with reporting upon the valuation on soil properties of the lands near the beach in order to set the afforestation site. The results are as follows : 1. In disaster-damage prevention forests, crown surface area and crown volume became increasingly greater in proportion to the height. To D.B.H., crown volume also became increasingly greater in proportion, but crown surface area was directly proportional. 2. In comparison to sail characteristics of sand dune, those of the forests were in large quantity in OM, T-N and avail. $SiO_2$, and almost in the same in avail. $P_2O_5$, but in small quantity in exchangeable canons : K, Ca, Mg and Na. 3. EC, Cl and pH were in small value in the forest soils, but CEC was in large value in those soils. 4. Above facts showed that the forests fulfill their functions for preventing disaster-damages and improve their soil properties. 5. The forests have naturally been thinned up to 34% in 17 years and 39% in 11 years, and one can easily pass through the forest(planted in 1970), because of its sufficient clear-length(2.71m) and its space to pass. 6. A plan for afforestation was oracle nut after judging several sites by the evaluation on the soil properties and considering the best relaxation and the prevention of the various disaster-damages upon which were reported in the last issue. 7. Afforestation should be kept for maintaining its appropriate density for best relaxation and disaster-damage prevention.

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The Effect of Pleural Thickening on the Impairment of Pulmonary Function in Asbestos Exposed Workers (석면취급 근로자에서 늑막비후가 폐기능에 미치는 영향)

  • Kim, Jee-Won;Ahn, Hyeong-Sook;Kim, Kyung-Ah;Lim, Young;Yun, Im-Goung
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.923-933
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    • 1995
  • Background: Pleural abnormality is the the most common respiratory change caused by asbestos dust inhalation and also develop other asbestos related disease after cessation of asbestos exposure. So we conducted epidemiologic study to investigate if the pleural abnormality is associated with pulmonary function change and what factors are influenced on pulmonary function impairment. Methods: Two hundred and twenty two asbestos workers from 9 industries using asbestos in Korea were selected to measure the concentration of sectional asbestos fiber. Ouestionnaire, chest X-ray, PFT were also performed. All the data were analyzed by student t-test and chi-square test using SAS. Regressional analysis was performed to evaluate important factors, for example smoking, exposure concentration, period and the existence of pleural thickening, affecting to the change of pulmonary function. Results: 1) All nine industries except two, airborn asbestos fiber concentration was less than an average permissible concentration. PFT was performed on 222 workers and the percentage of male was 88.3%, their mean age was $41{\pm}9$ years old, and the duration of asbestos exposure was $10.6{\pm}7.8$ yrs. 2) The chest X-ray showed normal(89.19%), pulmonary Tb(inactive)(2.7%), pleral thickening (7.66%), suspected reticulonodular shadow(0.9%). 3) The mean values of height, smoking status, concentration of asbestos fiberwere not different between the subjects with pleural thickening and others, but age, cumulative pack-years, the duration of asbestos exposure were higher in subjects with pleural thickening. 4) All the PFT indices were lower in the subjects with pleural thickening than in the subjects without pleural thickening. 5) Simple regression analysis showed there was a significant correlation between $FEF_{75}$ which is sensitive in small airway obstruction and cumulative smoking pack-years, the duration of asbestos exposure and the concentration of asbestos fiber. 6) Multiple regression analysis showed all the pulmonary function indices were decreased as the increase of cumulative smoking pack-years and especially in the indices those are sensitive in small airway obstruction. Pleural thickening was associated with reduction in FVC, $FEV_1$, PEFR and $FEF_{25}$. Conclusion: The more concentration of asbestos fiber and the more duration of asbestos exposure, the greater reduction in $FEF_{50}$, $FEF_{75}$. Therefore PFT was important in the evaluation of early detection for small airway obstruction. Furthermore pleural thickening without asbesto-related parenchymal lung disease is associated with reduction in pulmonary function.

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Trend of Medical Care Utilization and Medical Expenditure of the Elderly Cohort (노인 코호트의 의료이용 및 입원진료비 변화 추이 -공.교 의료보험 대상자를 대상으로-)

  • Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.437-461
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    • 1997
  • Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

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