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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.
( Hye Yeon Chon ),( Tae Seop Lim ),( Mi Young Jeon ),( Hye Won Lee ),( Beom Kyung Kim ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Kwang-hyub Han ),( Seung Up Kim ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Risk prediction models for hepatocellular carcinoma (HCC) development have been proposed. However, the influence of antiviral therapy (AVT) on these models in patients with chronic hepatitis B (CHB) is unknown. Methods: We investigated the dynamics of risk prediction models during AVT and the association between on-treatment values from these models and the risk of HCC development. Results: Between 2005 and 2017, 6,098 patients with CHB (1,758 non-cirrhotic, 4,340 cirrhotic) in whom AVT was initiated with entecavir (n=3,818) or tenofovir (n=2,280) were recruited. The mean age of the study population was 49.1 years and 61.4% (n=3,742) of the patients were male. The mean CU-HCC value was 12.7 at baseline in the entire study population; it was significantly lower (mean, 8.6) after 1-year of AVT (P< 0.001) and was maintained throughout 5-years of AVT (mean, 8.2-8.4; P >0.05). The proportion of high-risk patients (CU-HCC score ≥ 20) was 28.9% at baseline, which significantly decreased after 1-year of AVT (4.8%; P< 0.001) and was then maintained through 5-years of AVT (2.6-3.5%; P >0.05). The CU-HCC score after 1-year of AVT independently predicted the risk of HCC development (hazard ratio=1.037), together with age, male gender, liver cirrhosis, and platelet count (all P<0.05). Similar findings were obtained when the REACH-B criteria were used for non-cirrhotic patients. Conclusions: CU-HCC and REACH-B scores were significantly lower after 1-year of AVT and were maintained thereafter. CU-HCC and REACH-B scores after 1-year of AVT independently predicted the risk of HCC development in patients with CHB in whom AVT was initiated.
Non-infected and Infected Bronchogenic Cyst: The Correlation of Image Findings with Cyst Content
Jeon, Hong Gil,Park, Ju Hwan,Park, Hye Min,Kwon, Woon Jung,Cha, Hee Jeong,Lee, Young Jik,Park, Chang Ryul,Jegal, Yangjin,Ahn, Jong-Joon,Ra, Seung Won The Korean Academy of Tuberculosis and Respiratory 2014 Tuberculosis and Respiratory Diseases Vol.76 No.2
We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.
Jeon, Janet Ye-Won,Yoo, Seung-Hyun,Kim, Hye-Kyeong Korean Society for Health Education and Promotion 2012 보건교육건강증진학회지 Vol.29 No.2
Objectives: The objective of the study was to examine the clustering patterns and correlates of multiple health behaviors (MHBs) in middle-aged Koreans with metabolic syndrome (MetS). Methods: Data on sociodemographics, clinical characteristics, health behaviors (vegetable intake, physical activity, cigarette smoking, and alcohol consumption), and psychological characteristics were collected by a self-reported survey and medical examination from 331 individuals with MetS. Clustering of MHBs was examined by measuring 1) the ratios of observed and expected prevalence of MHBs, and 2) the prevalence odds ratios. A binomial logistic regression were conducted. Results: Men were more likely than women to engage in multiple unhealthy behaviors. Clustering of smoking and heavy drinking was exhibited in the participants. Women with high vegetable intake were more likely to be physically inactive, and those with inadequate vegetable intake were more likely to be physically active. Those with lower self-regulation were more likely to engage in unhealthy behaviors. Conclusions: The findings support the multiple health behavior approach as opposed to the individual health behavior approach. Emphasis of self-regulation is necessary in developing multiple behavior intervention for individuals with MetS.
S-536 : A case of serotonin syndrome caused by linezolid
( Won Jong Choi ),( Young Hee Nam ),( Soo Keol Lee ),( Dong Sub Jeon ),( Hye Won Lee ),( Hee Joo Nam ),( So Hee Lee ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Serotonin yndrome (SS) is a potentially life-threatening drug reaction characterized by mental status changes, increased neuromuscular tone, and autonomic instability. Linezolid, an oxazolidinone antibacterial agent, is widely used in general hospitals, however, which interacts some serotonin agonists and may cause SS. We report a case of SS caused by linezolid without the concomitant use of serotonin agonist. A 72-year-old patient was admitted for recurrent wound infection on his left ankle. He developed fever, skin rash and renal function deterioration, and blood eosinophil and liver enzymes increased after administration of vancomycin. Antibiotic therapy was changed to linezolid for methicillin-resistant Staphylococcus aureus. Four days later, he developed agitation, fever (38.6℃), hypertension (200/100 mm Hg) and tachycardia (130 beats/minute). There were no abnormal findings on laboratory and image tests including brain and chest computed tomography as causes for his symptoms. He had not taken any serotonin agonists including serotonin uptake inhibitor and monoamineoxidase-inhibiting antidepressants. The administration of linezolid was stopped. His symptoms improved within 24 hour, and had fully recovered within 2 days without additional treatment.Serotonin syndrome (SS) is a potentially life-threatening drug reaction characterized by mental status changes, increased neuromuscular tone, and autonomic instability. Linezolid, an oxazolidinone antibacterial agent, is widely used in general hospitals, however, which interacts some serotonin agonists and may cause SS. We report a case of SS caused by linezolid without the concomitant use of serotonin agonist. A 72-year-old patient was admitted for recurrent wound infection on his left ankle. He developed fever, skin rash and renal function deterioration, and blood eosinophil and liver enzymes increased after administration of vancomycin. Antibiotic therapy was changed to linezolid for methicillin-resistant Staphylococcus aureus. Four days later, he developed agitation, fever (38.6℃), hypertension (200/100 mm Hg) and tachycardia (130 beats/minute). There were no abnormal findings on laboratory and image tests including brain and chest computed tomography as causes for his symptoms. He had not taken any serotonin agonists including serotonin uptake inhibitor and monoamineoxidase-inhibiting antidepressants. The administration of linezolid was stopped. His symptoms improved within 24 hour, and had fully recovered within 2 days without additional treatment.