• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.1
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• pp.280-292
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• 1997

The purpose of this study was to assess the sedative effect of three kinds of medication for management of the uncooperative 60 children aged from 16 months to 87 months required extensive treatment. The patients were given randomly a dose of 75mg/kg of chloral hydrate and hydroxyzine 25mg orally or 0.5mg/kg of midazolam orally or 0.3mg/kg of midazolam intranasally. All the children were restrained in a Pediwrap and were monitored with Pulse oximeter for assessing the safety of patients. According to rating scale, sleep, crying, movement, and overall behavior were checked for evaluation of the clinical sedative effect. The results were as follows: 1. In the evaluation of sleep, rating scale of chloral hydrate/hydroxyzine was superior to the other group(p<0.05). 2. In the evaluation of crying and movement at beginning of treatment, rating scale of chloral hydrate/hydroxyzine was superior to the other group(p<0.05), but during the treatment, rating scale of each group was not significantly different (p>0.05). 3. In the evaluation of overall behavior, 80% children of chloral hydrate/hydroxyzine were rated good or very good. With the oral and intranasal midazolam, 60% children were rated good or very good respectively. 4. There were no clinical signs of significant cyanosis and respiratory depression. Clinically, chloral hydrate/hydroxyzine was proved to be more effective sedation than any other sedative method. Oral and intranasal midazolam were also safe and effective sedation in young children undergoing pediatric dental procedures.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.55-59
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• 2000

Background: Intrathecal injection of morphine is widely used in the management of postoperative pain because it provides long-lasting analgesia. Intramuscular caroverine and tiaprofenate are used to produce postoperative pain relief. This study was designed to evaluate the analgesic efficacy and quality of sleep achieved with intrathecal morphine and those of intramuscular caroverine and tiaprofenate in transurethral resection of the prostate (TURP). Methods: Forty patients undergoing elective TURP were randomly allocated into 2 groups as follows: Group M (n=20); 0.25 mg of morphine hydrochloride mixed in 7.5 mg of 0.5% hyperbaric bupivacaine was administered at the time of induction of spinal anesthesia. Group S (n=20); 7.5 mg of 0.5% hyperbaric bupivacaine was administered intrathecally and caroverine and tiaprofenate intramuscularly at every 8 hr and 12hr postoperatively for management of postoperative pain. We evaluated the analgesic efficacy with visual analog scale (VAS), quality of sleep, and side effects. Results: VAS at 6, 12 and 24 hours after operation were significantly less (p<0.01) in the group M than in the group S. Group M was superior to group S with respect to quality of sleep (p<0.01). In the group M, the incidence of nausea was 30% (6/20) and that of pruritus was 35% (7/20) and clinical respiratory depression did not occur. Conclusions: Intrathecal 0.25 mg morphine provides good postoperative analgesic effect. but intramuscular caroverine and tiaprofenate does not.

• 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.

• Korean Journal of Veterinary Research
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• v.49 no.4
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• pp.297-307
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• 2009

Animal shelters are potentially vulnerable to constant exposure to a variety of diseases for both animals and humans, because thousands of animals with unknown histories are being admitted to each shelter on a yearly basis in Korea. The control of disease spread, therefore, can be a major challenge to veterinarians in most shelters. This study investigated the health status of stray dogs admitted to the Gwangju Animal Shelter during the year of 2008, and analyzed types of disorders at the time of admission as well as newly acquired diseases while housed in the shelter. Canine heartworm disease was the most prevalent infection among stray dogs at the time of admission, while the respiratory disorder was the most common shelteracquired disease. The majority of dogs (93.5%) was either small or middle-sized breeds with Maltese (19.7%) and Shih Tzu (16.0%) being the most commonly found stray dogs. Out of 1,143 dogs admitted to the shelter, owners of 128 dogs (11.2%) visited the shelter and found their lost dogs, while 518 dogs (45.3%) were adopted to new families. Results of this study strongly indicate that stray dogs in Korea are exposed to a variety of diseases and the disease control by veterinarians is one of the most important aspects of the shelter management.

• Journal of the Korean Data and Information Science Society
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• v.22 no.3
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• pp.389-400
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• 2011

This study was carried out to analysis factors related to in-hospital mortality of community-acquired peumonia using administrative database. The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge Injury Survey 2004-2006 data. The data were analyzed using chi-squared test and decision tree model in the data mining technique. Among the decision tree model, C4.5 had the best performance. The critical factors on in-hospital mortality of communityacquired pneumonia are admission route, respiratory failure, congenital heart failure including age, comorbidity, and bed size. This study was carried out using the administrative database including patients' characteristics and comorbidity. However further study should be extensively including hospital characteristics, regional medical resources, and patient management practice behavior.

• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.2 s.3
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• pp.101-106
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• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.1
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• pp.7-12
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• 2010

Background: This study was carried out to contribute to effective management of operated patients by analyzing cooperative details about patients who were taken elective operation and consulted to the department of anesthesiology. Patients and Methods: One thousand patients who have been consulted to department of Anesthesiology, Chonnam National University Hospital from 2008. November to 2009. March were analyzed. The gender, age, cooperative departments, cooperative reason, the number of cancelled cases and cancelled reason were evaluated. Results: Among 1000 patients, there were 470 females and 530 males. After adjusting for age, middle-aged people which range 45 to 64 year-old are 39.9% and over 65 year-old people are 30.3%. Cooperative department is distributed to orthopedics which is highest occupying 20.6%, neurosurgery, otorhinolaryngology, obstetrics and gynecology in order. Dentistry occupied 2.0%. By specifying reasons of cooperation, cardiovascular diseases distribute to 38.4% which is the highest, the respiratory diseases, 17.5% and the endocrine diseases including diabetes 13.2%. Arranging details, hypertension is 23.9%, ECG abnormality 14.5%, chronic bronchitis in chest radiographic interpretation 14.2%. Of 1,000 consulted patients, delayed or cancelled cases are 58. And the reasons were 26 cases of need of appropriate the blood-sugar level. 26 cases needed appropriate treatment for comorbidities and others 6. Conclusion: Thoroughly evaluating patients before operation and maintenace of active cooperative system between operative department and anesthesiology department can contribute to reduction of cancellation rate and effective management of both hospitalizing and operating rooms.

• Health Policy and Management
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• v.10 no.3
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• pp.169-187
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• 2000

Cigarette smoking has been identified as the most important source of preventable morbidity and premature mortality (WHO, 1995), The prevalence of smoking among men is very high in Korea. This study estimated productivity losses due to smoking in Korea, 1997. The derivation of cost estimates for mortality, disability, hospitalization and use of physician services related to cigarette smoking is bas 어 on the calculation of attributable fractions suggested by MacMahon and Cole and Smoking-Attributable Mortality, Morbidity, and Economic Cost(SAMMEC) software. To estimate the number of deaths from neoplastic, cardiovascular, respiratory diseases associated with cigarette smoking, estimates for adults(aged 20 years and over) were based on 1997 mortality data, 1995 data on smoking prevalence from Korea Institute for Health and Social Affairs. Smoking-attributable indirect morbidity cost data were obtained from the National Federation of Medical Insurance. As the result of cost estimation, these productivity losses were 336-430 billion won. During 1997, 8,620-10,804 deaths were attributed to smoking. Cigarette smoking resulted in 133,991-169,422 Years of Potential Life Lost (YPLL) to life expectancy. For smoking -attributable indirect mortality costs, the present value of future earnings(PVFE) for the age at death are 299-384 billion won. Smoking-attributable indirect morbidity costs, the costs of lost productivity for persons who are disabled by smoking-related chronic diseases are 37-46 billion won. In this study the productivity losses due to smoking were restricted to the health effects of smoking. It is possible that these costs were underestimated with the limitation of the data. Smoking is the leading preventable cause of illness and death. The results of this study can be used as elementary data for antismoking policy.

• Journal of Digital Convergence
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• v.16 no.7
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• pp.259-265
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• 2018

Compartment models, a type of mathematical model, have been widely applied to characterize the changes in a dynamic system with sequential events or processes, such as the spread of an epidemic disease. A compartment model comprises compartments, and the relations between compartments are depicted as boxes and arrows. This principle is similar to that of the system dynamics (SD) approach to constructing a simulation model with stocks and flows. In addition, both models are structured using differential equations. With this mutual and translatable principle, this study, in terms of SD, translates a reference SEIR model, which was developed in a recent study to characterize the transmission of the Middle East respiratory syndrome (MERS) in South Korea. Compared to the replicated result of the reference SEIR model (Model 1), the translated SEIR model (Model 2) demonstrates the same simulation result (error=0). The results of this study provide insight into the application of SD relative to constructing an epidemic compartment model using schematization and differential equations. The translated SD artifact can be used as a reference model for other epidemic diseases.