Association of Atopic Dermatitis with Dyslipidemia in Adolescents: A Cross-Sectional Study

( Ja-ho Leigh ),( Hee Jae Park ),( Seong-min Chun ),( Yu-sun Min ),( Mira Choi ) 대한피부과학회 2021 Annals of Dermatology Vol.33 No.5

Epidemiological Trends and Rehabilitation Utilization of Traumatic Brain Injury in Korea (2008–2018)

김한결,Leigh Ja-ho,Kim Tae-Woo,오병모 대한뇌신경재활학회 2021 뇌신경재활 Vol.14 No.3

This study aimed to estimate the trend of traumatic brain injuries (TBIs) and TBI-related medical usage in Korea. Patients first diagnosed with disease codes of TBIs were included. We calculated the crude incidence and age-adjusted incidence, as well as medical cost, length of stay (LOS), clinic visits, and the number of specialized rehabilitation therapy for 1 year. Patients first diagnosed as TBI was higher in national health insurance (NH- I) than in automobile insurance (AUTO-I). In contrast with the gradual decrease of the crude incidence, total medical costs both in NH-I and AUTO-I were generally and steadily increased. For oriental medicine, total medical costs dramatically increased in both inpatient and outpatient. LOS, clinic visits, and the number of specialized rehabilitation therapy were higher in AUTO-I than in NH-I. The most frequent age groups in NH-I were the young (0–9) and old (70 or over), whereas in AUTO-I, the working age group was prominent. Our results show differences in the incidence of TBI and medical usage between NH-I and AUTO-I, which could be associated with the policy for strengthening health insurance coverage, automobile-related regulations to prevent accidents and injuries, as well as rapid changes in the structure of the population in Korea

Trends in the Incidence and Etiology of Non-Traumatic Spinal Cord Injury in Korea: A Nationwide Population-Based Study From 2007 to 2020

Choi Yoonjeong,Leigh Ja-Ho,Jeon Jooeun,Lee Goo Joo,Shin Hyung-Ik,Bang Moon Suk 대한의학회 2023 Journal of Korean medical science Vol.38 No.18

Background: Although patients with non-traumatic spinal cord injury (NTSCI) have distinct epidemiological characteristics compared to those with traumatic spinal cord injury, no previous study has reported the incidence of NTSCI on a national scale in Korea. In this study, we examined the trend in incidence of NTSCI in Korea and described the epidemiological characteristics of patients with NTSCI using nationwide insurance data. Methods: National Health Insurance Service data were reviewed for the period from 2007 to 2020. The International Classification of Diseases, 10th revision, was used to identify patients with NTSCI. Inpatients with newly diagnosed NTSCI on their first admission during the study period were included. Crude incidence was calculated using the annual number of NTSCI cases divided by the mid-year population estimates. Age-specific incidence was calculated by dividing the number of cases in 10-year age groups by the total number of individuals in that age group. Age-adjusted incidence was calculated using direct standardization. Annual percentage changes were calculated using Joinpoint regression analysis. The Cochrane-Armitage trend test was conducted to examine the trends of NTSCI incidence according to the types or etiologies of NTSCI. Results: The age-adjusted incidence of NTSCI increased continuously from 24.11 per million in 2007 to 39.83 per million in 2020, with a significant annual percentage change (4.93%, P < 0.05). The age-specific incidence for those in their 70s and 80s or older was the highest and rapidly increased from 2007 to 2020. According to the types of paralysis in NTSCI, the proportion of tetraplegia decreased, whereas those of paraplegia and cauda equina increased significantly from 2007 to 2020. The proportion of degenerative diseases was the largest among all etiologies and increased significantly during the study period. Conclusion: The annual incidence of NTSCI in Korea is increasing significantly, particularly among older adults. As Korea is one of the countries with most rapidly aging population in the world, these results have significant implications, indicating that preventive strategies and sufficient rehabilitation medical services are warranted for the population of older adults.

Epidemiology of Traumatic and Non-Traumatic Spinal Cord Injury in Korea: A Narrative Review

Yoonjeong Choi,Ja-Ho Leigh 대한신경손상학회 2023 Korean Journal of Neurotrauma Vol.19 No.4

This review describes the incidence rates and trends of traumatic spinal cord injuries (TSCI) and non-traumatic spinal cord injuries (NTSCI) in South Korea. The incidence of NTSCI has increased more rapidly than that of TSCI in recent years. In 2007, TSCI was more common, but by 2020, NTSCI had surpassed TSCI, particularly in older individuals. While men have a higher incidence of both TSCI and NTSCI, the incidence difference by sex is greater in TSCI. The incidence rates of both TSCI and NTSCI are higher in older individuals, particularly those in their 70s and 80s. For TSCI, falls and traffic accidents are the most common causes, with falls being more prevalent in older adults. Cervical SCIs are the most common TSCI, especially in high-income countries like South Korea. Patients with NTSCI predominantly display paraplegia, which is usually associated with non-traumatic causes such as degenerative disorders and tumors. Higher rates of tetraplegia and paraplegia are observed with TSCI and NTSCI, respectively. The neurological levels of injury also differ between TSCI and NTSCI. Overall, SCIs are a growing concern in South Korea and there is a need for targeted interventions for their management and prevention, especially in older age groups.

Spinal Cord Injury Fact Sheet in Korea

Han-Kyoul KIM,Ja-Ho Leigh,Yoonjeong Choi,Jong Hwa Lee,Moon Suk Bang 대한재활의학회 2023 Annals of Rehabilitation Medicine Vol.47 No.1

Spinal cord injury (SCI) has been recognized as a medically complex and life-disrupting condition. As the aging of the population accelerates, the trend of SCI has changed. This review aimed to provide comprehensive statistics and recent epidemiological changes in SCI and rehabilitation in Korea. All three insurance databases (National Health Insurance Service [NHIS], automobile insurance [AUI], and industrial accident compensation insurance [IACI]) were considered. These nationwide databases provide data on the current trends in term of incidence, etiology, and rehabilitation of SCI. Traumatic spinal cord injury (TSCI) was more frequent among the elderly in the NHIS compared to working age individuals in the AUI and IACI. In all three trauma-related insurance databases, male with TSCI outnumbered female. TSCI incidence per year was approximately 17 times higher among males than females, on average, in IACI. In all three insurances, the cervical level of TSCI was the most frequent. Although the ratio of SCI patients receiving rehabilitation treatment at primary and secondary hospitals increased for nine years, the increase in training on activities of daily living (ADL training) was found to be relatively small. This review provides a broader and comprehensive understanding of the incidence, etiology, and rehabilitation treatment of SCI in Korea.

Value of the Frontal Assessment Battery Tool for Assessing the Frontal Lobe Function in Stroke Patients

Mihyang Han,Da-Ye Kim,Ja-Ho Leigh,Min-Wook Kim 대한재활의학회 2020 Annals of Rehabilitation Medicine Vol.44 No.4

Objective To examine the correlation between the Frontal Assessment Battery (FAB) test, which is used to assess the frontal lobe function, and anatomical lesions as well as the ability of the test to detect frontal lobe dysfunction. Methods Records of stroke patients undergoing a FAB test and Mini-Mental State Examination (MMSE) were retrospectively reviewed. The patients were divided into three groups according to the lesions determined by an imaging study: frontal lobe cortex lesions, frontal subcortical circuit lesions, and other lesions. The FAB scores of the three groups were compared using the Kruskal-Wallis test. The validity of the FAB test to detect frontal lobe dysfunction was assessed by a comparison with the Computerized Neuropsychological Function Test (CNT) using the Spearman correlation coefficient. The correlation coefficients between the FAB test and MMSE were analyzed further based on the MMSE cutoff score. Results Patients with frontal cortex lesions had significantly lower total and subtest scores according to the FAB test than the other patients. The FAB test correlated better with the CNT than the MMSE, particularly in the executive function and memory domains. A high MMSE score (r=0.435) indicated a lower correlation with the FAB test score than a low MMSE score (r=0.714). Conclusion The FAB test could differentiate frontal lobe lesions from others in stroke patients and showed a good correlation with the CNT. Moreover, the FAB test can be used in patients with high MMSE scores to detect frontal lobe dysfunction and determine the treatment strategies for stroke patients.

A New Disability-related Health Care Needs Assessment Tool for Persons With Brain Disorders

Kim, Yoon,Eun, Sang June,Kim, Wan Ho,Lee, Bum-Suk,Leigh, Ja-Ho,Kim, Jung-Eun,Lee, Jin Yong The Korean Society for Preventive Medicine 2013 Journal of Preventive Medicine and Public Health Vol.46 No.5

Objectives: This study aimed to develop a health needs assessment (HNA) tool for persons with brain disorders and to assess the unmet needs of persons with brain disorders using the developed tool. Methods: The authors used consensus methods to develop a HNA tool. Using a randomized stratified systematic sampling method adjusted for sex, age, and districts, 57 registered persons (27 severe and 30 mild cases) with brain disorders dwelling in Seoul, South Korea were chosen and medical specialists investigated all of the subjects with the developed tools. Results: The HNA tool for brain disorders we developed included four categories: 1) medical interventions and operations, 2) assistive devices, 3) rehabilitation therapy, and 4) regular follow-up. This study also found that 71.9% of the subjects did not receive appropriate medical care, which implies that the severity of their disability is likely to be exacerbated and permanent, and the loss irrecoverable. Conclusions: Our results showed that the HNA tool for persons with brain disorders based on unmet needs defined by physicians can be a useful method for evaluating the appropriateness and necessity of medical services offered to the disabled, and it can serve as the norm for providing health care services for disabled persons. Further studies should be undertaken to increase validity and reliability of the tool. Fundamental research investigating the factors generating or affecting the unmet needs is necessary; its results could serve as basis for developing policies to eliminate or alleviate these factors.

Effect of Focal Muscle Vibration on Calf Muscle Spasticity: A Proof-of-Concept Study

Seo, Han Gil,Oh, Byung-Mo,Leigh, Ja-Ho,Chun, Changmook,Park, Cheol,Kim, Choong Hyun Elsevier 2016 PM&R Vol.8 No.11

<P>Background: Focal vibration has been studied for its ability to reduce spasticity in patients with upper motor neuron lesions, but adequate stimulation parameters remain unclear. Focal muscle vibration with adequate parameters may facilitate gait rehabilitation in patients with lower limb spasticity. Objective: To determine focal muscle vibration parameters that effectively inhibit the H-reflex of the gastrocnemius in healthy subjects. Design: A proof-of-concept exploratory study. Setting: University hospital laboratory. Subjects: Thirteen healthy volunteers. Methods: Focal muscle vibrations of 40, 80, and 120 Hz and amplitudes of 0.1, 0.3, and 0.5 mm were tested on the calf muscles of 10 healthy subjects, respectively. The H-reflex and M-response were recorded baseline, during vibration, and after vibration for each stimulation parameter. The mean vibratory inhibition index (VII) during vibration, the maximum amplitude of the H-reflex and M-response (H-max and M-max), minimal onset latency of the H-reflex, and the ratio of H-max to M-max (HMR) at each time point were measured. Results: No significant difference was found among mean VIIs at 40, 80, and 120 Hz in the healthy subjects. However, a relatively consistent reduction of H-max and HMR was observed at 80 Hz. Mean VI's at 0.3 and 0.5 mm were significantly lower than that at 0.1 mm (P < .001). Conclusion: This study suggests that focal muscle vibration may be an adjuvant therapy during gait rehabilitation in patients with calf muscle spasticity. Focal vibration at 80 Hz and 0.3 mm amplitude applied to the gastrocnemius effectively inhibits the segmental reflex pathway. A future clinical trial on this topic is warranted.</P>

The Socioeconomic Burden of Acquired Brain Injury among the Korean Patients over 20 Years of Age in 2015–2017: a Prevalence-Based Approach

Lee Ye Seol,Lee Hoo Young,Leigh Ja-Ho,Choi Yoonjeong,김한결,오병모 대한뇌신경재활학회 2021 뇌신경재활 Vol.14 No.3

Acquired brain injury (ABI) is a leading cause of serious long-term disability resulting in substantial economic costs for post-ABI care. This study was conducted to estimate the socioeconomic burden of persons with ABI in Korea. We used a prevalence-based approach and societal perspective to estimate the direct medical, non-medical costs and indirect costs of ABI, including stroke, traumatic brain injury (TBI), and non-traumatic ABI (anoxia, brain tumor, encephalitis, meningitis, hydrocephalus, and other brain disorders) from 2015 to 2017. The study population included patients with ABI over 20 years of age and analyzed according to insurance types encompassing National Health Insurance and automobile insurance. The socioeconomic burden of ABI was 4.67, 5.18, and 5.73 trillion KRW (approximately 4,162, 4,612, and 5,106 million USD) from 2015 to 2017 and around 0.3% of Korea's GDP annually. Estimating by disease, the socioeconomic cost was 72.4% for stroke, 18.6% for TBI, and 9.0% for non-traumatic ABI. Calculated by cost component, medical costs and non-medical costs showed a slight increase every year. Through this study, establishment of rehabilitation systems maximizing the health and quality of life for injured persons remain the key public health strategy for ABI to reduce socioeconomic burden and financial policies to support patients should be needed

Comparison of Trends in the Incidence of Traumatic Spinal Cord Injury in Daily Life, Automobile Accidents, and Industrial Accidents: A National Multi-Insurance Study in Korea

Choi Yoonjeong,Kim Young-Eun,Leigh Ja-Ho,Lee Ye Seol,Kim Han-Kyoul,Yi You Gyoung,Lee Jinyoung,Lee Min-Yong,Lee Gangpyo,신형익,방문석 대한의학회 2023 Journal of Korean medical science Vol.38 No.7

Background: To examine the incidence of traumatic spinal cord injury (TSCI) from all etiologies, we measured and compared the incidence of TSCI from three national or quasinational databases in South Korea, namely, the National Health Insurance Service (NHIS), automobile insurance (AUI), and Industrial Accident Compensation Insurance (IACI). Methods: We reviewed patients with TSCI reported in the NHIS database between 2009 and 2018, and in the AUI and IACI databases between 2014 and 2018. TSCI patients were defined as those first admitted to the hospital with a diagnosis of TSCI according to the International Classification of Diseases (10th revision) criteria. Age-adjusted incidence was calculated using direct standardization using the 2005 South Korean population or the 2000 US population as the standard population. The annual percentage changes (APC) of TSCI incidence were calculated. The Cochrane–Armitage trend test was performed according to the injured body region. Results: In the NHIS database, age-adjusted TSCI incidence using the Korean standard population increased significantly from 2009 to 2018 (from 33.73 per million in 2009 to 38.14 per million in 2018, APC = 1.2%, P = 0.014). Contrarily, age-adjusted incidence in the AUI database significantly decreased from 13.88 per million in 2014 to 11.57 per million in 2018 (APC = – 5.1%, P = 0.009). In the IACI database, the age-adjusted incidence showed no significant difference, while crude incidence showed a significant increase (from 22.02 per million in 2014 to 28.92 per million in 2018, APC = 6.1%, P = 0.038). According to the age group, all the three databases showed high incidences of TSCI in those in their 60s and 70s or older. Among those in their 70s or older, the incidence of TSCI increased dramatically in the NHIS and IACI databases, while no significant trend was found in AUI database. In 2018, the number of TSCI patients was the highest among those over 70 years of age in the NHIS, whereas among those in their 50s were the highest in both AUI and IACI. The proportion of patients with cervical spinal cord injury was the most common in all these databases. Conclusions: The differences in trends in the incidence of TSCI may be due to the different etiologies and different characteristics of subjects depending on insurance type. These results imply the need for tailored medical strategies for the different injury mechanisms represented by three national insurance services in South Korea.