• 대한한의학회지
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• 제24권3호
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• pp.165-171
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• 2003

Objective : Stroke is the second major cause of death in Korea. It is known that the survival and ultimate outcome in stroke depend on various factors, so it is not easy to predict unexpected death in stroke. This study was performed in order to find predicting factors of unexpected death in stroke. Methods : A retrospective study was accomplished by reviewing 21 medical records of stroke patients who expired in the ward of Kyung Hee Oriental Medical Center from January 1998 to December 2001. Data analyzed Were physical examination, laboratory findings, clinical charts and APACH III scoring system. Results : I. The number of unexpected deaths at the ward of Kyung Hee Oriental Medical Center from January in 1998 to December in 2001 were 21 patients (0.1%). 2. Major risk factors of unexpected death were age (${\geq}60$), high blood pressure on 1st admission day and acute stage (${\leq}30{\;}days$). 3. The most frequent time of unexpected death was from 6 a.m. to noon. 4. Major cause of unexpected death was recurrence of stroke (40%). 5. APACH III scores of 75% of unexpected death patients were over 30 points. 6. Clinical change of symptoms 3 or 4 days before the unexpected death were dyspnea, change of urination and defecation. Conclusion; This mortality study suggests that old age, high blood pressure on 1st admission day, acute stage, and high APACH III score are the major predictors of unexpected death in stroke patients and that intensive medical attention is necessary to reach a better outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.353-356
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• 2016

Background: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) for glassy cell carcinoma data to identify predictive models and potential disparities in outcome. Materials and Methods: This study analyzed socio-economic, staging and treatment factors. For risk modeling, each factor was fitted by a generalized linear model to predict the cause specific survival. Area under the receiver operating characteristic curves (ROCs) were computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate modeling errors. Risk of glassy cell carcinoma death was computed for the predictors for comparison. Results: There were 79 patients included in this study. The mean follow up time (S.D.) was 37 (32.8) months. Female patients outnumbered males 4:1. The mean (S.D.) age was 54.4 (19.8) years. SEER stage was the most predictive factor of outcome (ROC area of 0.69). The risks of cause specific death were, respectively, 9.4% for localized, 16.7% for regional, 35% for the un-staged/others category, and 60% for distant disease. After optimization, separation between the regional and unstaged/others category was removed with a higher ROC area of 0.72. Several socio-economic factors had small but measurable effects on outcome. Radiotherapy had not been used in 90% of patients with regional disease. Conclusions: Optimized SEER stage was predictive and useful in treatment selection. Underuse of radiotherapy may have contributed to poor outcome.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.63-64
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• 1995

• 한국의사학회지
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• 제27권2호
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• pp.145-157
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• 2014

The "Annals of the Joseon Dynasty (朝鮮王朝實錄)" is the precious historical material which contains royal culture of Joseon dynasty as an official document. It kept a record of the diseases and treatments relating to the 27 Kings for a period of 518 years, who had a variety of different symptoms. Among them the most frequent disease was a skin disorder such as a boil of a painful infected swelling. Dermatosis became the direct cause of death of several Kings. In this article we tried to conduct research using the "Annals of the Joseon Dynasty" into the skin diseases of the Kings during the first period of Joseon dynasty from the first King Taejo (太祖) to the 12th King Injong (仁宗). Among the 12 Kings, the 5th King Munjong (文宗), the 7th King Sejo (世祖), the 9th King Seongjong(成宗), the 10th King Yeonsangun (燕山君), and the 11th King Jungjong suffered from dermatosis. The King Munjong died at the age of 38 and suffered from severe boils before his death. The cause of death is thought to be septicaemia. The King Sejo does not have any specific record of skin disease, however, the recently discovered relics showed the indications of serious skin trouble of boils. The King Seongjong suffered from skin diseases at the age of 20, 27, 28 and 38. Nevertheless, the direct cause of death was not dermatosis. The King Yeonsangun had skin trouble of boils on his face when he was 20. He lost the throne and died of an infectious disease at 31. The King Jungjong had a record of suffering from dermatosis at the beginning of twenties, at the middle of forties, and at the age of 57 when he died. The skin trouble affected the whole of the body. He was treated with acupuncture therapy and medication for both internal and external uses among which folk remedies were included.

• 대한안전경영과학회지
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• 제8권1호
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• pp.85-96
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• 2006

The oriental life change unit(LCU) models differ from the western LCU model in human behavior, life style, ideas, culture, and psychology factors. Especially, the cause and effect models by behavior scientific approach method have provided the accident proneness concept through the LCU factors. Therefore this paper describes the analytical results of the oriental LCU model and western LCU model. Especially, the death of parents and death of close friend in Korean LCU model feel more acute stress than the western factors. In the case of Korean LCU models between the unmarried and married workers living in the middle area of Korea, death of parents, change in family member's health, change to different line of work, and change in work hours and condition are significant at the significance level of 5%. The priority of life change factors in these models is approved in the order of death of parents, death of spouse, death of close family member, and death of close friend. Finally, the result of this paper can be easily used in order to minimize the industrial accidents by the job stress with the worker and safety manager in real fields.

• 보험의학회지
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• 제3권1호
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• pp.269-273
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• 1986

We have examined 5,304 cases of claims by death that had occured for recent three years from January, 1983 to November, 1985 in Dae han kyoyuk Ins. Co. As a result, we came to following conclusions: 1. The total numbers of the deaths are increased for three years, but the deaths, classifying by medical examinations are decreased. 2. The great part of the death were due to Accident death(27.7%), occupied Number 1, malignant neoplasm(23.9%) Number 2 and Circulatory system disease(23.9%), which were the main canses of death in the insured people. 3. With age, section ranging from 30-39 years of death cases took extremely large portions by 35.2%. 4. For the period elapsed, the deaths within 2 years to ander 3 years, 18.6%, above 6 years, 18.6%, thus the period elapsed was longer more and more as years go. 5. By the deaths of malignant neoplasm, hepatoma in male and gastric cancer in female were important causes of death.

• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.191-199
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• 2001

Objective : In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost(SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. Results : The following results were obtained in this study: 1) Premature death that is attributable to smoking in males could be prevented in 60.9%(513,582 person-year) by non-smoking. 2) The burden of premature death by smoking for female was prevented to 17.7%(513,582 person-year) by non-smoking. Conclusion : We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.75-82
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• 2010

Purpose: In Korea, trauma is the $3^{rd}$ most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have. Methods: The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score). Results: A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate. Conclusion: One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.867-870
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• 2014

Purpose: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) ependymoma data to identify predictive models and potential disparity in outcome. Materials and Methods: This study analyzed socio-economic, staging and treatment factors available in the SEER database for ependymoma. For the risk modeling, each factor was fitted by a Generalized Linear Model to predict the outcome ('brain and other nervous systems' specific death in yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate the modeling errors. Risk of ependymoma death was computed for the predictors for comparison. Results: A total of 3,500 patients diagnosed from 1973 to 2009 were included in this study. The mean follow up time (S.D.) was 79.8 (82.3) months. Some 46% of the patients were female. The mean (S.D.) age was 34.4 (22.8) years. Age was the most predictive factor of outcome. Unknown grade demonstrated a 15% risk of cause specific death compared to 9% for grades I and II, and 36% for grades III and IV. A 5-tiered grade model (with a ROC area 0.48) was optimized to a 3-tiered model (with ROC area of 0.53). This ROC area tied for the second with that for surgery. African-American patients had 21.5% risk of death compared with 16.6% for the others. Some 72.7% of patient who did not get RT had cerebellar or spinal ependymoma. Patients undergoing surgery had 16.3% risk of death, as compared to 23.7% among those who did not have surgery. Conclusion: Grading ependymoma may dramatically improve modeling of data. RT is under used for cerebellum and spinal cord ependymoma and it may be a potential way to improve outcome.

• Journal of Preventive Medicine and Public Health
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• 제37권4호
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• pp.345-352
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• 2004

Objectives : Previous studies showed that death certification by physicians was an important predictor to improve the quality of death certificate data in South Korea. This study was conducted to examine the proportion of death certificates issued by physicians and associated factors in South Korea from 1990 to 2002. Methods : Data from 3,110,883 death certificates issued between 1990 and 2002, available to the public from the National Statistical Office of Korea, were used to calculate the proportion of death certificates issued by physicians and to examine associated factors with logistic regression analysis. Results : The overall proportion of death certificates issued by physicians increased from 44.6% in 1990 to 77.6% in 2002 (mean: 63.5%). However, the proportion was greatly influenced by the deceased's age. In 2002, more than 90% of the deceased aged 51 or less were certified by physicians. A higher proportion was found among deceased who had tertiary education (college or higher) living in more developed urban areas. Conclusion : The information regarding the cause of death for younger, well-educated deceased in urban areas of South Korea may show a higher level of accuracy. Epidemiologic research using information on causes of death may well benefit from the continually increasing proportion of death certificates issued by physicians in the future in South Korea.