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김혜경,이정운,박강원,문옥륜,Kim, Hye-Kyung,Lee, Jeon-Un,Park, Kang-Won,Moon, Ok-Ryun 대한예방의학회 1992 Journal of Preventive Medicine and Public Health Vol.25 No.3
The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows : It was found that. cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible($15{\sim}49$ years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates : In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three deplendent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the valiance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has veen found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.
우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계
강혜영,강대룡,장영화,박성은,최원정,문성환,양규현,Kang, Hye-Young,Kang, Dae-Ryong,Jang, Young-Hwa,Park, Sung-Eun,Choi, Won-Jung,Moon, Seong-Hwan,Yang, Kyu-Hyun 대한예방의학회 2008 예방의학회지 Vol.41 No.5
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.
( Hye Kyung Song ),( Ki Nam Shim ),( Hye Won Yun ),( Chung Hyun Tae ),( Chang Mo Moon ),( Seong Eun Kim ),( Hye Kyung Jung ),( Tae Hun Kim ),( Sung Ae Jung ),( Kwon Yoo ),( Il Hwan Moon ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Caustic ingestion can cause severe injury to upper gastrointestinal track. There were a few studies about clinical characteristics and treatments of caustic injury in Korea. We investigated the changes of caustic injury over 20 years in clinical characteristics including the pattern of endoscopic mucosal injury and the modality of treatments. Methods: This study was a retrospective review of medical records from patients with caustic injury from September 1993 through December 2012. Patients with caustic injury who visited hospital from 1993 to 2002 were classifi ed as early period group and patients with caustic injury who visited from 2003 to 2012 were classifi ed as late period group. Results: A total 140 patients (mean age 44±17 yrs, male 41.7%) were included [early period group (n= 50) vs. late period group (n= 90)]. Annual incidence of caustic ingestion did not decrease (range 2-20) over 20 years. Ingestion of alkali agents increased (10% vs. 57%, p<0.0001) and more than grade 2B of mucosal injury decreased (47.8% vs. 27.3%, p=0.0015) in late period group. There was no difference between two groups in sex, age, proportion of accidental ingestion, systemic and GI complication. Use of gastric lavage, NPO and broad spectrum antibiotics decreased in late period group (p<0.01). However, there was no difference in use of steroid between two groups (p=0.172). Conclusions: There was no decreasing trend in caustic ingestion and ingestion of alkali agents increased over the past 20 years. The tighter legislation on caustic agents is required and we need to be alert to the best management of caustic injury.
( Hye Won Jang ),( Dae Hyun Tak ),( Beom Hee Kim ),( Hee Seok Moon ),( Eaum Seok Lee ),( Seok Hyun Kim ),( Byung Seok Lee ),( Heon Young Lee ),( Byung Seok Lee ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
Background/Aims: In several previous study, insulin resistance has a harmful effect on treatment of chronic viral hepatitis C. We aimed to elucidate the impact of insulin resistance in treatment outcome of Korean Chronic hepatitis C patients. Methods: 152 Korean CVH-C patients were recruited and they were all treated with peginterferon plus ribavirin. All the patient`s ALT, triglyceride, cholesterol, fasting plasma glucose, body mass index were reviewed. Results: In 152 patients, 127 patients attained SVR and 25 did not. The mean FPG of SVR group was 118.3 ± 5.0 , whereas 142.0 ± 15.5 in non- SVR group and it has no significance (p=0.48). The mean TG level of SVR group and non-SVR group were 108.1 ± 4.8 and 116.6 ± 11.6, each. (p=0.08). In 25 DM patients, only 5 (3.9%) patients were succeed in attaining SVR (p=0.00). TG and fasting plasma glucose level were associated with attainment of SVR in CVH-C patients by multivariate logistic regression analysis ( TG ,Odds ratio = 2.65, p=0.049 ; FPG, Odds ratio=3.16, p=0.042). Conclusion: In Peginterferon treated Korean patients, who have high fasting plasma glucose and triglyceride level prone to fail in attainment of SVR.
HCV : PE-098 ; Myasthenia gravis triggered by antiviral therapy for chronic hepatitis C
( Hye In Kim ),( Tae Hun Kim ),( Il Hwan Moon ),( Kwon Yoo,),( Sun Young Yi ),( Sung Ae Jung ),( Ki Nam Shim ),( Hye Kyung Jung ),( Seong Eun Kim ),( Won Yung Cho ),( So Yoon Yoon ),( Eun Mi Song ),( 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
Myasthenia gravis (MG) is an uncommon disease characterized by muscular weakness and fatigability, caused in 85% of the cases by Acetylcholine receptor (AChR) antibodies. And it is reported as a rare side effect of interferon administration which can develop during chronic hepatitis C treatment. And about 15% of MG patients have thymoma while half of the patients with thymoma eventually develop MG. But it is hardly reported that MG was triggered by antiviral therapy in patient with thymoma. We experienced a rare case of myasthenia gravis induced by antiviral therapy for chronic hepatitis C in patient with mediastinal thymoma. A 47-year-old male complained of diplopia after 9 weeks of administration of peginterferon and ribavirin. A brain imaging study showed no abnormality but we diagnosed as MG by positive repetitive nerve stimulation test and positive anti AChR antibody. And we found thymoma after chest CT scan.
Pcp-2 Interacts Directly with Kinesin Superfamily KIF21A Protein
Hye-Young Park(박혜영),Sang-Jin Kim(김상진),Sung Su Ye(예성수),Won Hee Jang(장원희),Sang Kyeong Lee(이상경),Yeong-Hong Park(박영홍),Yong Wook Jung(정용욱),Il Soo Moon(문일수),Moo Seong Kim(김무성),Dae-Hyun Seog(석대현) 한국생명과학회 2008 생명과학회지 Vol.18 No.8
KIF21A는 kinesin superfamily에 속하는 분자 motor로서 미세소관을 따라서 분비소포를 운반한다. 최근의 연구결과 KIF21A 유전자 일부의 missense 돌연변이에 의하여 congenital fibrosis of the extraocular muscles (CFEOM)1의 유발됨이 밝혀졌다. CFEOM1은 KIF21A의 돌연변이로 인하여 분화 발생과정에 occulo-motor신경과 neuromuscular junction 형성에 필요한 단백질을 이동시키지 못함으로써 유발된다. 본 연구에서는 효모 two-hybrid system을 사용하여 KIF21A의 WD-40 repeat domain과 결합하는 분자량이 작은 Purkinje cell protein-1 (Pcp-2), 또는 L7으로도 알려진 단백질을 분리하였다. Pcp-2는 효모 two-hybrid assay에서 KIF21A와 KIF21B의 WD-40 영역과는 결합하지만 다른 종류의 KIFs와는 결합하지 않았다. 또한 단백질간의 특이적 결합을 pull-down assay로 확인 하였으며, 생쥐의 뇌 파쇄액에 Pcp-2 항체로 면역침강을 행하여 KIF21A를 확인한 결과 Pcp-2와 같이 침강하였다. 이러한 결과들은 KIF21A는 Pcp-2와 결합하며, 또한 Pcp-2는 KIF21A의 adaptor 단백질로서 세포 내 KIF21A의 수송에서 매개 단백질로 작용함을 시사한다. KIF21A is a member of the Kinesin superfamily proteins (KIFs), which are microtubule-dependent molecular motors, anterograde axonal transporters of cargoes. Recently, congenital fibrosis of the extraocular muscles 1 (CFEOM1) has been shown to result from a small number of recurrent heterozygous missense mutations of KIF21A. CFEOM1 results from the inability of mutated KIF21A to successfully deliver cargoes to the development of the occulo-motor neuron or neuromuscular junction. Here, we used an yeast two-hybrid system to identify a protein that interacts with the WD-40 repeat domain of KIF21A and found a specific interaction with Purkinje cell protein-2 (Pcp-2), a small protein also known as L7. Pcp-2 protein bound to the WD-40 domain of KIF21A and KIF21B but not to other KIFs in yeast two-hybrid assays. In addition, this specific interaction was also observed in the glutathione S-transferase pull-down assay. An antibody to Pcp-2 specifically co-immunoprecipitated KIF21A associated with Pcp-2 from mouse brain extracts. These results suggest that Pcp-2 may be involved in the KIF21A-mediated transport as a KIF21A adaptor protein.
A Trend Analysis of the Prevalence, Awareness, Treatment, and Control of Hypertension by Age Group
Moon, Jong Youn,Park, Kwan Jun,Hwangbo, Young,Lee, Mee Ri,Yoo, Byoung In,Won, Jong Hye,Park, Yoon Hyung The Korean Society for Preventive Medicine 2013 Journal of Preventive Medicine and Public Health Vol.46 No.6
Objectives: We examined the trends in prevalence, awareness, treatment, and control of hypertension in Korea as a basis for improving hypertension control programs. Methods: 12 598 participants of the Korean National Health and Nutrition Examination Survey were included in this study. Weighted linear regression to test time trends from 2007 to 2011 was performed. Results: The prevalence of hypertension was 20.7% in 2007, 29.4% in 2009, and 26.2% in 2011. Awareness of hypertension was 64.8% in 2007 and 61.1% in 2011. Awareness in those aged 65 and over was greater than in younger groups (age 19 to 44 and 45 to 64; p<0.001). The treatment rates were 58.4% in 2007 and 56.8% in 2011. The treatment rate was greater for those 65 and over than for younger age groups (p<0.001). The percentage of controlled hypertension was 37.6% in 2011. The percentage of controlled hypertension in those 65 and over was higher than in younger age groups (p<0.001). The treatment-control rates were 65.9% in 2007 and 67.7% in 2011. The prevalence of hypertension was higher in the males (p<0.001), while the awareness (p<0.001), treatment (p<0.001), and control (p<0.001) rates were higher in the females. Conclusions: The prevalence of hypertension was increasing and the hypertension awareness, treatment, and control rates were low in younger age groups and males.