• Journal of Preventive Medicine and Public Health
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• v.53 no.4
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• pp.289-292
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• 2020

Yemen has been faced with the worst cholera epidemic of modern times, with more than 1 million suspected cases and 3000 deaths at the time of writing. This problem is largely due to the longstanding civil war between pro-government forces and the Houthi armed movement, which has severely damaged already vulnerable sanitation and healthcare facilities and systems in the country. It is further compounded by a dire lack of basic amenities, chronic malnutrition, and unfavourable weather conditions. Another contributory component may be aerial transfer by cholera-infected chironomid insects. To contain the spread of cholera in Yemen, a nation-wide armistice should be negotiated, and national and local committees must be convened to coordinate efforts on the ground. Community isolation facilities with proper sanitation, reliable disposal systems, and a clean water supply should be set up to isolate and treat sick patients. The continuity of vaccination programmes should be ensured. Public health campaigns to educate local communities about good hygiene practices and nutrition are also necessary. The One Health paradigm emphasizes a multi-sectoral and transdisciplinary understanding and approach to prevent and mitigate the threat of communicable diseases. This paradigm is highly applicable to the ongoing cholera crisis in Yemen, as it demands a holistic and whole-of-society approach at the local, regional, and national levels. The key stakeholders and warring parties in Yemen must work towards a lasting ceasefire during these trying times, especially given the extra burden from the mounting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak worldwide.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.183-190
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• 2001

Objective : To estimate the annual economic costs attributable to cigarette smoking in Korea. Methods : The costs were classified as being direct medical and non-medical costs, indirect costs and others. We focused on those costs related that are incurred in the treatment of selected diseases (cardiovascular diseases, respiratory diseases, and cancers), which have been proven to be caused by smoking. In addition to the basic costs of treatment, the additional amount of costs occurred due to smoking was obtained by computing the population attributable risk (PAR%) caused by smoking. To compute the PAR%, relative risks of smoking to the number of outpatient visits, hospitalizations, and the death were estimated using the Cox proportional hazard model, respectively. Our major data source was the 'Korea Medical Insurance Corporation (KMIC) cohort study,' which was composed of a total of 115,682 male and 67,932 female beneficiaries who had complete records of their smoking histories in the year of 1992. Results : The annual costs that could be attributable to smoking were estimated to be in the range of 2,847,500 million Won to 3,959,100 million Won. The maximum estimate of 3,959,100 million Won includes 233,100 million Won for medical costs, 5,100 million Won for transportation costs, 27,600 million Won for care giver's economic costs, 69,100 million Won in productivity loss, 3,435,000 million Won lost because of premature death, 172,100 million Won in costs resulting from passive smoke inhalation and 17,100 million Won for costs that resulted from fires that were caused by careless smoking. Conclusion : Our study confirms that the magnitude of the economic burden of smoking to Korean society is substantial. Therefore, this study provides strong evidence that there is a strong need for a national policy of tobacco control in Korea.

• BMB Reports
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• v.36 no.1
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• pp.95-109
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• 2003

Inflammatory lung diseases are characterized by chronic inflammation and oxidant/antioxidant imbalance. The sources of the increased oxidative stress in patients with chronic inflammatory lung diseases such as asthma and chronic obstructive pulmonary disease (COPD) derive from the increased burden of inhaled oxidants, and from the increased amounts of reactive oxygen species (ROS) generated by several inflammatory, immune and various structural cells of the airways. Increased levels of ROS produced in the airways is reflected by increased markers of oxidative stress in the airspaces, sputum, breath, lungs and blood in patients with lung diseases. ROS, either directly or via the formation of lipid peroxidation products such as 4-hydroxy-2-nonenal may play a role in enhancing the inflammation through the activation of stress kinases (JNK, MAPK, p38) and redox sensitive transcription factors such as NF-${\kappa}B$ and AP-1. Recent evidences have indicated that oxidative stress and pro-inflammatory mediators can alter nuclear histone acetylation/deacetylation allowing access for transcription factor DNA binding leading to enhanced pro-inflammatory gene expression in various lung cells. Understanding of the mechanisms of redox signaling, NF-${\kappa}B$/AP-1 regulation, the balance between histone acetylation and deacetylation and the release and expression of pro- and anti-inflammatory mediators may lead to the development of novel therapies based on the pharmacological manipulation of antioxidants in lung inflammation and injury. Antioxidants that have effective wide spectrum activity and good bioavailability, thiols or molecules which have dual antioxidant and anti-inflammatory activity, may be potential therapeutic agents which not only protect against the direct injurious effects of oxidants, but may fundamentally alter the underlying inflammatory processes which play an important role in the pathogenesis of chronic inflammatory lung diseases.

• Journal of Society of Preventive Korean Medicine
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• v.24 no.2
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• pp.31-41
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• 2020

Background : The introduction of policies expanding the coverage of uninsured Korean Medicine (KM) services have requires an understanding of the following components of the service : current financial expenses, degree of financial burden on the patient, and financial effect of the coverage expansion. Objectives : This study aims to determine the annual trend of outpatients' characteristics and the category of out-of-pocket spending in KM. Methods : This study uses data from the Korea Health Panel to analyze use of KM in the Korean population. Using the user characteristics and behavior drawn from the Korea Health Panel data, out-of-pocket spending trends of KM were analyzed by year. The diagnosis and prescription of out-of-pocket spending were also analyzed. Results : The proportion of patients receiving uninsured medical treatment and the number of uninsured medical treatment in outpatient clinics have increased. However, the average out-of-pocket spending per person and out-of-pocket spending per visit are consistent or have decreased. Meaningful trends are the increase of R00-R99 (unclassified symptoms) and the decrease of K00-K93 (digestive system disease) and J00-J99 (respiratory system disease). Conclusions : Expansion of KM medical service and insurance is influenced by uninsured medical treatment of KM. Hence, research to increase medical treatment categories for out-of-pocket spending or explore diseases where KM diagnosis has been proven effective should be further developed.

• Health Policy and Management
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• v.30 no.3
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• pp.286-300
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• 2020

In 2019, the Seoul metropolitan government established its own 'Seoul-type paid sick leave project'. Although the central government had to introduce such a system, which is also called sickness benefits, it was not implemented. In order to understand the process by which the Seoul government has implemented such a policy, this study used Kingdon's multiple streams framework. As a result, in the problem stream, it was found that the economic burden of sickness has been considered only in terms of medical expenses in the past of Korea. Then Songpa's three women and Middle East respiratory syndrome incidents raised awareness of the necessity of the sickness benefit system in 2014 and 2015. In the political stream, several social affairs such as national health insurance huge surpluses and the 2017 presidential election opened policy window. At that time, Seoul Mayor actively promoted sickness benefits as a policy entrepreneur. In the policy stream, the sickness benefit system has gained new attention through political events. To summary, these three streams flowed separately and then they assembled around huge political affairs. As a result, it was confirmed that Kingdon's model is the most effective theory than any other models in analyzing the health care policy decision process in Korea.

• Health Policy and Management
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• v.33 no.1
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• pp.29-39
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• 2023

Background: Breaking the chain of disease transmission from overseas is necessary to control new infectious diseases such as coronavirus disease 2019 effectively. In this study, we developed a mobile app called Self-Symptom Checker (SSC) to monitor the health of inbound travelers. Methods: SSC was developed for general users and administrators. The functions of SSC include non-repudiation using QR (quick response) codes, monitoring fever and respiratory symptoms, and requiring persons showing symptoms to undergo polymerase chain reaction tests at nearby screening stations following a review of reported symptoms by the Korea Disease Control and Prevention Agency, as well as making phone calls, via artificial intelligence or public health personnel, to individuals who have not entered symptoms to provide the necessary information. Results: From February 12 to March 27, 2020, 165,000 people who were subjected to the special entry procedure installed SSC. The expected number of public health officers and related resources needed per day would be 800 if only the phone was used to perform symptom monitoring during the above period. Conclusion: By applying SSC, more effective symptom monitoring was possible. The daily average number of health officers decreased to 100, or 13% of the initial estimate. SSC reduces the work burden on public healthcare personnel. SSC is an electronic solution conceived in response to health questionnaires completed by inbound travelers specified in the World Health Organization International Health Regulations as a requirement in the event of a pandemic.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.171-181
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• 2001

Background : Angiogenesis is an essential process for the growth and metastatic ability of solid tumors. One of the key factors known to be capable of stimulating tumor angiogenesis is the vascular endothelial growth factor (VEGF). The serum VEGF concentration has been shown to be a useful parameter related to the clinical features and prognosis of lung cancer and has been recently applied to a the malignant pleural effusion showing a correlation with the biochemical parameters. The VEGF has been shown to play a role in the inflammatory diseases, but rarely in the tuberculosis (TB). The serum and pleural fluid VEGF levels were measured in patients with lung cancer and TB. Their relationship with the clinical and laboratory parameters and repeated measurement 3 months after various anticancer treatments were evaluated to assess the utility of the VEGF as a tumor marker. Methods : Using a sandwich enzyme-linked immunosorbent assay, the VEGF conoentration was measured in both sera and pleural effusions collected from a total of 85 patients with lung cancer, 13 patients with TB and 20 healthy individuals. Results : The serum VEGF levels in patients with lung cancer ($619.9{\pm}722.8pg/ml$) were significantly higher than those of healthy controls ($215.9{\pm}191.1pg/ml$), However, there was no significant difference between the VEGF levels in the lung cancer and TB patients. The serum VEGF levels were higher in large cell and undifferentiated carcinoma than in squamous cell carcinoma and adenocarcinoma. The serum VEGF levels of lung cancer patients revealed no significant relationship with the various clinical parameters. The VEGF concentrations in the malignant effusion ($2,228.1{\pm}2,103.0pg/ml$) were significantly higher than those in the TB effusion ($897.6{\pm}978.8pg/ml$). In the malignant pleural effusion, the VEGF levels revealed significant correlation with the number of red blood cells (r=0.75), the lactate dehydrogenase (LDH)(r=0.70), and glucose concentration (r=-0.55) in the pleural fluid. Conclusion : The serum VEGF levels were higher in the lung cancer patients. The VEGF levels were more elevated in the malignant pleural effusion than in the tuberculous effusion. In addition, the VEGF levels in the pleural fluid were several times higher than the matched serum values suggesting a local activation and possible etiologic role of VEGF in the formation of malignant effusions. The pleural VEGF levels showed a significant correlation with the numbers of red blood cells, LDH and glucose concentrations in the pleural fluid, which may represent the tumor burden.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.331-336
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• 2007

Background: Although pulmonary tuberculosis (TB) is a respiratory disease, the presence of Mycobacterium tuberculosis (Mtb) DNA or Mtb itself has been reported in the peripheral blood (PB) of several patients with pulmonary TB. Additionally, it was recently announced that active pulmonary TB patients donated PB, and that this blood was then transfused to other individuals in Korea. Methods: Sixty-nine patients with bacteriologically-confirmed pulmonary TB (35), non-tuberculous mycobacterial (NTM) lung disease (6), and other lung diseases (28) were enrolled in this study, which was conducted to determine if Mtb DNA could be detected in the PB by PCR. In addition, 10 pulmonary TB patients with high-burden bacilli were also enrolled in this study for the culture of Mtb in PB. Results: PCR detected the presence of Mtb in 22.8% (8/35) of the pulmonary TB patients, in 16.7% (1/6) of the patients with NTM lung disease, and in none of the patients with other diseases (0%). In addition, no Mtb was cultured from the PB of the 10 pulmonary TB patients. Conclusion: Although Mtb DNA was detected in the PB of some patients with pulmonary TB, viable Mtb was not isolated from the PB of those patients, which indicates that patients that viable Mth may not be transmitted via trasfusion of blood of pulmonary TB patients.

• Biomedical Science Letters
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• v.17 no.4
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• pp.297-304
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• 2011

Influenza A virus of the Orthomyxoviridae family is a contagious respiratory pathogen that continues to evolve and burden in the human public health. It is able to spread efficiently from human to human and have the potential to cause pandemics with significant morbidity and mortality. It has been estimated that every year about 500 million people are infected with this virus, causing about approximately 0.25 to 0.5 million people deaths worldwide. Influenza A viruses are classified into different subtypes by antigenicity based on their hemagglutinin (HA) and neuraminidase (NA) proteins. The sudden emergence of influenza A virus subtypes and access for epidemiological analysis of this subtypes demanded a rapid development of specific diagnostic tools. Also, rapid identification of the subtypes can help to determine the antiviral treatment, because the different subtypes have a different antiviral drug resistance patterns. In this study, our aim is to detect influenza A virus subtypes by using real-time nucleic acid sequence based amplification (NASBA) which has high sensitivity and specificity through molecular beacon. Real-time NASBA is a method that able to shorten the time compare to other molecular diagnostic tools and is performed by isothermal condition. We selected major pandemic influenza A virus subtypes, H3N2 and H5N1. Three influenza A virus gene fragments such as HA, NA and matrix protein (M) gene were targeted. M gene is distinguished influenza A virus from other influenza virus. We designed specific primers and molecular beacons for HA, NA and M gene, respectively. In brief, the results showed that the specificity of the real-time NASBA was higher than reverse transcription polymerase chain reaction (RT-PCR). In addition, time to positivity (TTP) of this method was shorter than real-time PCR. This study suggests that the rapid detection of neo-appearance pandemic influenza A virus using real-time NASBA has the potential to determine the subtypes.

• Journal of Life Science
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• v.32 no.5
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• pp.375-390
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• 2022

Influenza viruses are zoonotic respiratory pathogens, and influenza infections have caused a substantial burden on public health systems and the livestock industry. Although currently approved seasonal influenza vaccines have shown potent protection efficacy against antigenically well-matched strains, there are considerable unmet needs for the efficient control of viral infections. Enormous efforts have been made to develop broadly protective universal influenza vaccines to tackle the huge levels of genetic diversity and variability of influenza viruses. In addition, antiviral drugs have been considered important interventions for the treatment of viral infections. The viral neuraminidase inhibitor oseltamivir is the most widely used antiviral medication to treat influenza A and influenza B viruses. However, unsatisfactory clinical outcomes resulting from side effects and the emergence of resistant variants have led to greater attention being paid to plants as a natural resource for anti-influenza drugs. In particular, the recent COVID-19 pandemic has underpinned the need for safe and effective antiviral drugs with a broad spectrum of antiviral activity to prevent the rapid spread of viruses among humans. This review outlines the results of the antiviral activities of various natural products isolated from plants against influenza viruses. Special focus is paid to the virucidal effects and the immune-enhancing effects of antiviral natural products, since the products have broad applications as inactivating agents for the preparation of inactivated vaccines and vaccine adjuvants.