- Factors Influencing Utilization of Medical Care Among Osteoarthritis Patients in Korea: Using 2005 Korean National Health and Nutrition Survey Data.
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Min Young Kim, Jong Ku Park, Sang Baek Koh, Chun Bae Kim
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J Prev Med Public Health. 2010;43(6):513-522.
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DOI: https://doi.org/10.3961/jpmph.2010.43.6.513
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The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. METHODS: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. RESULTS: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant difference between whether the medical utilization in men patients. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant difference between whether the medical utilization in women patients. CONCLUSIONS: The patients who tend to receive less care are those suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.
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Citations
Citations to this article as recorded by  - Associations Between Fat Mass, Lean Mass, and Knee Osteoarthritis: The Fifth Korean National Health and Nutrition Examination Survey (KNHANES V)
Seong Rae Kim, Kyung-Hyun Choi, Go-Un Jung, Doosup Shin, Kyuwoong Kim, Sang Min Park
Calcified Tissue International.2016; 99(6): 598. CrossRef - Convergence analysis of determinants affecting on geographic variations in the prevalence of arthritis in Korean women using data mining
Yoo-Mi Kim, Sung-Hong Kang
Journal of Digital Convergence.2015; 13(5): 277. CrossRef - The relative importance of perceived doctor’s attitude on the decision to consult for symptomatic osteoarthritis: a choice-based conjoint analysis study
Domenica Coxon, Martin Frisher, Clare Jinks, Kelvin Jordan, Zoe Paskins, George Peat
BMJ Open.2015; 5(10): e009625. CrossRef - Complementary and alternative medicine use of women with breast cancer: Self-help CAM attracts other women than guided CAM therapies
Deborah N.N. Lo-Fo-Wong, Adelita V. Ranchor, Hanneke C.J.M. de Haes, Mirjam A.G. Sprangers, Inge Henselmans
Patient Education and Counseling.2012; 89(3): 529. CrossRef
- Assessment on Quality Improvement of the Abstracts of the Original Research Articles in the Korean Journal of Preventive Medicine.
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Chun Bae Kim, Jun Ho Park, Hwa Soon Lee, Jong Ku Park, Bong Suk Cha
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Korean J Prev Med. 2003;36(2):179-186.
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To compare the quality improvement of the abstracts of original articles, according to the revised manuscript format, of the Korean Journal of Preventive Medicine (Korean J Pre Med) was adopted in 1999. METHODS: A total 63 abstracts for 1997, and 49 for 2001, were selected as the original articles from the Kor J Pre Med. This study was carried out by the separate-sample pretest-posttest design. The quality of the abstracts was measured by a checklist of Narine' evaluation criteria, and the other information related to the articles were also surveyed by e-mail and fax or telephone using a self-made questionnaire. From the response rate, a total of 62 abstracts for 1997 and 49 for 2001 were finally analyzed. RESULTS: The mean number of words in an abstract decreased from 285 in 1997, to 250 by 2001. The mean number of key words per abstract decreased from 3.9 in 1997, to 3.6 by 2001. The mean number of inappropriate usage of key words per abstract, by the MeSH standard, decreased from 1.9 in 1997, to 0.4 by 2001. Also, the overall mean score of abstract quality increased from 0.54 in 1997 to 0.61 by 2001. The range of scores for the abstract quality was better in 2001 (0.40~0.77) than in 1997 (0.20~0.81). From the multiple regression analyses of the 1997 and 2001 databases, the intervention of the manuscript format's revision, and the number of English words to the quality score of the abstract, were the only statistically significant factors. CONCLUSIONS: In conclusion, the quality of abstracts in the Kor J Pre Med has improved since the revised manuscript format was adopted in 1999. The Korean Society for Preventive Medicine will continuously recommend proposals for more informative abstracts in their journal, and will evaluate the abstracts' content with quality criteria. Future studies should address these issues, and compare the quality of abstracts between different international and domestic journals.
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- A Meta-analysis of the Association between Blood Lead and Blood Pressure.
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Sang Baek Koh, Chun Bae Kim, Chung Mo Nam, Hong Ryul Choi, Bong Suk Cha, Jong Ku Park, Ho Sung Jee
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Korean J Prev Med. 2001;34(3):262-268.
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To integrate the results of studies which assess an association between blood lead and blood pressure. METHODS: We surveyed the existing literature using a MEDLINE search with blood lead and blood pressure as key words, including reports published from January 1980 to December 2000. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers exposed to lead, and 2) both blood pressure and blood lead must have been measured and presented with sufficient details so as to estimate or calculate the size of the association as a continuous variable. Among the 129 articles retrieved, 13 studies were selected for quantitative meta-analysis. Before the integration of each regression coefficient for the association between blood pressure and blood lead, a homogeneity test was conducted. RESULTS: As the homogeneity of studies was rejected in a fixed effect model, we used the results in a random effect model. Our quantitative meta-analysis yielded weighted regression coefficients of blood lead associated with systolic blood pressure and diastolic blood pressure results of 0.0047 (95% confidence interval [CI]: -0.0061, 0.0155) and 0.0004 (95% CI: -0.0031, 0.0039), respectively. CONCLUSIONS: The published evidence suggested that there may be a weak positive association between blood lead and blood pressure, but the association is not significant.
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- Risk Factors for Cerebrovascular Disorders in Koreans.
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Jong Ku Park, Ki Soon Kim, Chun Bae Kim, Tae Yong Lee, Duk Hee Lee, Kwang Wook Koh, Kang Sook Lee, Sun Ha Jee, Il Suh, So Yeon Ryu, Kee Ho Park
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Korean J Prev Med. 2001;34(2):157-165.
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To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. METHODS: The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (I60-I68) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. RESULTS: In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. CONCLUSION: We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.
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- A Nested Case Control Study on Risk Factors for Coronary Heart Disease in Korean.
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Ki Soon Kim, So Yeon Ryu, Jong Park, Jong Ku Park, Chun Bae Kim, Byung Yeol Chun, Tae Yong Lee, Kang Sook Lee, Duk Hee Lee, Kwang Wook Koh, Sun Ha Jee, Il Suh
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Korean J Prev Med. 2001;34(2):149-156.
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To elucidate risk factors for coronary heart diseases among Korean males. METHODS: A nested case control study was conducted among a Korea Medical Insurance Cooperation(KMIC) cohort composed of 108,802 males. The cases included 246 male patients who were admitted to hospital due to coronary heart diseases from 1993 to 1997 (I20-25 by ICD) and whose diagnosis was confirmed by the protocol by WHO MONICA Project(1994). The control group was composed of 483 patients selected by frequency matching considering age and resident area from an inpatient care group without coronary heart disease during the same period. For study cases and the controls, the results of a health check-up in 1990 and a questionnaire on life style in 1992 were received through the KMIC. Some additional information was collected by telephone interviews during October 1999. RESULTS: Multiple logistic regression analysis showed that the odds ratio(OR) of coronary heart diseases among past smokers and current smokers as compared to non-smokers were 1.94(95% CI : 1.14-3.31) and 2.20(95% CI : 1.35-3.59), respectively. The OR among persons who drank 4 cups or more of caffeinated beverages such as coffee or tea daily as compared to persons who drank one cup for 2-3 days was 2.56(95% CI : 1.07-6.12). The OR among persons with high normal BP and stage 3 hypertension against normotension were 2.51(95% CI : 1.44-4.37) and 5.08(95% CI : 2.38-10.84). The OR among persons whose blood cholesterol were 240 mg/dL or more against lower than 200mg/dL was 2.24(95% CI : 1.43-3.49). CONCLUSION: Smoking, drinking of excessive caffeinated beverages, hypertension and high blood cholesterol were proven to be significant risk factors for coronary heart diseases among Korean males.
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- A Meta-analysis on the Association between Chronic Noise Exposure and Blood Pressure.
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Chun Bae Kim, Sang Baek Koh, Jai Young Kim, Bong Suk Cha, Hong Ryul Choi, Jong Tae Lee, Chung Mo Nam, Sang Yun Lee, Seung jun Wang, Keeho Park, Dae Youl Kim
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Korean J Prev Med. 2000;33(3):343-348.
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This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. METHODS: Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. RESULTS: All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studies were accomplished in a resting state, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. CONCLUSIONS: Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.
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- The Accuracy of ICD codes for Cerebrovascular Diseases in Medical Insurance Claims.
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Jong Ku Park, Ki Soon Kim, Chun Bae Kim, Tae Yong Lee, Kang Sook Lee, Duk Hee Lee, Sunhee Lee, Sun Ha Jee, Il Suh, Kwang Wook Koh, So Yeon Ryu, Kee Ho Park, Woonje Park, Seungjun Wang, Hwasoon Lee, Yoomi Chae, Hyensook Hong, Jin Sook Suh
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Korean J Prev Med. 2000;33(1):76-82.
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We attempted to assess the accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. METHODS: A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met one of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. RESULTS: The accuracy rate of the ICMIC was 83.0% (425 cases). Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. CONCLUSION: The accuracy rate of the ICMIC was 83.0%.
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- Meta-analysis on the Blood Lipids as Risk Factors of Coronary Heart Diseases in Koreans.
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So Yeon Ryu, Ki Soon Kim, Yang ok Kim, Jong Park, Jong Ku Park, Chun Bae Kim, Sun Ha Jee
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Korean J Prev Med. 1999;32(4):491-493.
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To determine the relations between seven blood lipids such as total cholesterol(TC), triglyceride(TG), HDL-cholesterol(HDL), LDL-cholesterol(LDL), apolipoprotein A-1(Apo A1), apolipoprotein B(Apo B) and lipoprotein(a)(Lp(A)) and the coronary heart diseases(CHD), the quantitative techniques of meta-analysis were applied to studies of blood lipids and CHD in Koreans. METHODS: We searched the Korean and the English literature published from 1980 to August, 1997 by manual search and bibliography review. Information on sample size, study design, participant characteristics(gender, age) and blood lipid levels were abstracted by reviewers using inclusion criteria. Estimates of the effect sizes of blood lipid levels on CHD in Koreans and corresponding 95% confidence intervals were calculated using random-effect models. RESULTS: We identified 16 case-control studies to apply meta-analysis. The overall effect sizes for CHD were 20.3(95% CI : 14.23-26.22) in TC, 24.8(95% CI : 12.6-36.86) in TG, 15.16(95% CI : 3.99 - 26.33) in LDL, -3.48(95% CI : -5.79 - -1.17) in HDL, -9.78(95% CI : -16.98 - -2.58) in Apo-a1, 17.88(95% CI : 9.72 - 26.05) in Apo B and 18.95(95% CI : 17.88 - 20.02) in Lp(a). CONCLUSIONS: Our results suggested that seven blood lipids were significantly associated with CHD in Koreans. Well-designed and prospective studies between blood lipids and CHD in Koreans should be performed.
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- What Factors Affect Mortality over the Age of 40?.
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Jong Ku Park, Sang Baek Koh, Chun Bae Kim, Myung Guen Kang, Kee Ho Park, Seung Jun Wang, Sei Jin Chang, Soon Ae Sin
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Korean J Prev Med. 1999;32(3):383-394.
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This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. METHODS: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. RESULTS: In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. CONCLUSIONS: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.
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- A Meta-analysis of Ambient Air Pollution in Relation to Daily Mortality in Seoul, 1991~1995.
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Jong Tae Lee, Douglas W Dockery, Chun Bae Kim, Sun Ha Jee, Yong Chung
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Korean J Prev Med. 1999;32(2):177-182.
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To reexamine the association between air pollution and daily mortality in Seoul, Korea using a method of meta-analysis with the data filed for 1991 through 1995. METHODS: A separate Poisson regression analysis on each district within the metropolitan area of Seoul was conducted to regress daily death counts on levels of each ambient air pollutant, such as total suspended particulates (TSP), sulfur dioxide (SO2), and ozone (O3), controlling for variability in the weather condition. We calculated a weighted mean as a meta-analysis summary of the estimates and its standard error. RESULTS: We found that the p value from each pollutant model to test the homogeneity assumption was small (p<0.01) because of the large disparity among district-specific estimates. Therefore, all results reported here were estimated from the random effect model. Using the weighted mean that we calculated, the mortality at a 100 microgram/m3 increment in a 3-day moving average of TSP levels was 1.034 (95% CI 1.009-1.059). The mortality was estimated to increase 6% (95% CI 3-10%) and 3% (95% CI 0-6%) with each 50 ppb increase for 3-day moving average of SO2 and 1-hr maximum O3, respectively. CONCLUSIONS: Like most of air pollution epidemiologic studies, this meta-analysis cannot avoid fleeing from measurement misclassification since no personal measurement was taken. However, we can expect that a measurement bias be reduced in a district-specific estimate since a monitoring station is better representative of air quality of the matched district. The similar results to those from the previous studies indicated existence of health effect of air pollution at current levels in many industrialized countries, including Korea.
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- Trends of Preventive Medicine Research according to The Korean Journal of Preventive Medicine and Qualitative Meta-analysis on Articles of Lead Poisoning.
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Chun Bae Kim, Jung Ae Rhee, Jong Ku Park, Seok Joon Sohn
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Korean J Prev Med. 1999;32(2):113-122.
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The purpose of this study was to describe the trends of original research in the Korean Journal of Preventive Medicine, and to evaluate the quality of original articles about lead poisoning. METHOD: The data for the analysis of trends in preventive medicine research was taken from a total of 829 original articles published in the Korean Journal of Preventive Medicine from 1968 to 1997. The qualitative meta-analysis was measured against a checklist of evaluation criteria, which were divided into 10 categories, with 46 articles on lead poisoning. The evaluation process was performed independently by two evaluators. RESULTS: The number of articles per 100 members over the study period increased by almost 4 pieces in the early 1980s, and by more than 9 pieces in the mid-1990s. In the major classifications of subjects, environmental and industrial health, epidemiology and health statistics, and health policy and management published 370 pieces (44.6%), 137 pieces (16.5%), 322 pieces (38.9%) respectively. In the order of the number of articles, five themes about health significance, including metal exposure (73 pieces), diseases associated with exposure to organic solvents (45 pieces), air pollution (36 pieces), maternal and child health (32 pieces), and occupational health (30 pieces) received consistent attention throughout the years 1968-1997. The overall mean score of article quality about lead poisoning was 37.8 out of 50. Of the articles any information on the purpose and hypothesis described well. Of those the originality of the subjects, the form of articles (including tables and figures), and the number of inappropriate words of abstracts showed very low score. For multiple regression analyses, the number of joint research institutes and the acceptance of research grants about the article quality were statistically significant. CONCLUSIONS: The number of original research reports in the Korean J Prev Med has recently increased and their subjects have diversified. Of the basis of this study, the articles need improvement in the areas of abstracts, tables and illustrations (figures), etc. The Korean Society for Preventive Medicine will revise contribution regulations for manuscripts submitted to the Korean J Prev Med. Future studies should address these issues and perform the quantitative mata-analysis about the specific subjects including the quality of articles.
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- Quality Assessment of the Abstracts of the Original Articles (1997) in the Korean Journal of Preventive Medicine.
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Jong Ku Park, Chun Bae Kim, Desmond Hannibal
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Korean J Prev Med. 1999;32(1):72-79.
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The purpose of this study was to evaluate the quality of abstracts of original articles. METHODS: This subjects selected total 63 abstracts of the original articles of the Korean Journal of Preventive Medicine in 1997. The quality of abstracts was measured against a checklist of evaluation criteria, which were divided into eight categories and the numbers of inappropriate words (including grammar) according to criterion-based survey. A score for each abstract was obtained by dividing the number of criteria presented by the number applicable. The overall mean score was also determined. RESULTS: The overall mean score of abstract quality was 0.55 out of 1. Of the abstracts subject selection 83% didn't include specific technical descriptors. Of those that gave conclusions 92% didn't address study limitations and 78% made no recommendations for future study. The overall mean number of inappropriate usage of words (including grammar) per abstract was 14.1. The overall mean number of English words was 283. In the multiple regression analyses, the research career of the first author and the number of English words to the number of inappropriate usage of words were statistically significant. Also, in the secondary regression model, the number of English words to the quality score of abstract was only statistically significant. CONCLUSIONS: Most of the abstracts provided some information pertaining to each evaluation criterion. However, they did not provide sufficient details to enhance the reader's understanding of the article. On the basis of the study the abstracts need improvement in its description of the reported subject selection, statements of limitations and recommendations, etc. The Korean Society for Preventive Medicine will recommend a proposal for more informative abstracts in Korean J Prev Med and will take into consideration the introduction of foreign review of abstracts. Future studies should address these issues and compare the quality of abstracts between different journals and their time of publication.
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- The effect of sodium and potassium intake on blood pressure change in Korean adolescents.
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Il Suh, Chung Mo Nam, Kang Hee Lee, Sun Ha Jee, Suk Il Kim, Gyu Sang Kim, Chun Bae Kim
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Korean J Prev Med. 1998;31(3):384-394.
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- In order to investigate the effect of the urinary excretion of sodium and potassium on the change on blood pressure over 3 years, 668 adolescents aged 13 years living in Kangwha area were investigated in a longitudinal follow-up study. Two measurements were taken on each blood pressure (diastolic, systolic) and the average of the two readings was used in the analysis. Sodium and potassium intake were estimated by the determination of those electrolytes in 24hr urine. The mixed model regression analysis was used to identify the effect of urinary sodium and potassium on the change of blood pressure after controlling for BMI of each age. On simple bivariate analysis no relationship was found between urinary sodium excretion and systolic or diastolic blood pressure among both male and female, however, a significant positive association between urinary potassium excretion and systolic blood pressure among male. The results of mixed regression analysis showed that the body mass index (BMI) were more influential that urinary electrolytes among this study subjects. It suggested that risk factors observed from the adults, may not be identical with that of the growing aged population. After control of the BMI and age, significant association between sodium and diastolic BP among male, and association between potassium and systolic BP among female, were found. In summary, the results indicate that growth has been more influential than dietary factor on blood pressure for growing aged population.
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- A Meta-analysis on the Risk Factors of Cerebrovascular Disorders in Koreans.
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Jong Ku Park, Myung Keun Kang, Chun Bae Kim, Ki Soon Kim, Sun Ha Jee
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Korean J Prev Med. 1998;31(1):27-48.
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- This study was conducted to integrate the results of studies which evaluated or identified the risk factors of CVD(cerebrovascular disorders) for Koreans. We retrieved the literature published in Korean by manual search and the English literature by Medline database to identify studies on the relationship between reported risk factors and CVD conducted for the Korean from 1980 to August, 1997. Hypertension and total serum cholestrol were selected as subjects of quantitative meta-analysis as risk factors of CVD in Koreans. The overall effect sizes of the risk of CVD due to hypertension and total serum cholesterol were calculated by common odds ratio(OR) and average standardized mean difference, retrospectively. Before the integration of each effect sizes into common effect sizes, the heterogeneity tests were conducted. Also, sensitivity tests were conducted for the estimated common effect sizes. Regarding hypertension and CVD, a total of 9 epidemiologic studies were identified with a total of 2,271 cases of CVD. The overall OR of hypertension associated CVD was 4.10(95% confidence interval[CI] 3.56 to 4.71). The OR of hypertension associated with hemorrhagic CVD and ischemic CVD were 6.56(95% CI : 4.92 to 8.80) and 3.28(95% CI : 2.77 to 3.90), retrospectively. The OR of hypertension in relation to hemorrhagic CVD was significantly higher than that of hypertension in relation to overall CVD or ischemic CVD. Regarding serum total cholesterol and ischemic CVD, total 9 epidemiologic studies were identified with a total of 843 cases of ischemic CVD. Average mean difference as an effect size was 0.76, which was judged an important value according to Cohen's criteria. Our data suggested that hypertension was an important risk factor of overall CVD and its subtypes, and that the total serum cholesterol was associated with ischemic CVD in Koreans. For the lack of reliable prospective studies, however, we concluded that further research designed longitudinally would be required in this area.
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- Meta-analysis of the Korean Literatures for Developing Clinical Practice Guidelines of Benign Prostatic hyperplasia.
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Seung Hum Yu, Chun Bae Kim, Myung Geun Kang, Jae Mann Song
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Korean J Prev Med. 1997;30(3):643-664.
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- This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing or pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.
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- Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents.
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Il Suh, Chung Mo Nam, Sun Ha Jee, Suk Il Kim, Young Ok Kim, Sung Soon Kim, Won Heum Shim, Chun Bae Kim, Kang Hee Lee, Jong Won Ha, Hyung Gon Kang, Kyung Won Oh
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Korean J Prev Med. 1997;30(2):308-326.
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- Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. a A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic diastolic BP at age 12 and 16 years old were 108.7 mmHg & 118.1 mmHg(systolic), and 69.5 mmHg & 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg & 113.5 mmHg(systolic) and 75.2 mmHg & 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index etc) increased consitantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend for females. Total fat intake increased at age 16 years compared with that at age 14 years. Composition of carbohydrate, protein and fat among total energy intake was 65:15:20 at age 14 and 16 years. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness, showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.
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Summary
- Survival Analysis of Hospitalized Mesothelioma Patients.
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Chun Bae Kim, Sang Hyuk Jung, Kyung Jong Lee, Jong Doo Kang
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Korean J Prev Med. 1990;23(1):77-86.
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- Between 1977 and 1987, 20 patients with mesothelioma were treated at Severance Hospital. Data was gathered from medical charts at the time of hospitalization of mesothelioma patients and from a follow-up questionnaire by mail or telephone. The results acquired were as follows: 1. Among the 20 patients, 11 men and 9 women with mesothelioma were identified. The mean age at hospitalization was 47 years and 11 mesothelioma patients were known or presumed to be dead during the different observation periods. 2. Only one mesothelioma patient had a definite history of occupational asbestos exposure. 3. The sites of orgin of mesothelioma were the pleura(13), peritoneum(2), pericardium(2), mediastinum(2), and pelvis(1). Common symptoms included dyspnea, chest pain, abdominal distension, etc. 4. Pathologically, mesotheliomas were divided into 14 malignant types and 6 benign types ; and histologically, 8 fibrous mesotheliomas and 3 epithelial mesotheliomas were shown. 5. There was a statistically significant difference in survival rate according to pathologic type and smoking status. In the groups with malignant mesothelioma, 50% survival time from first symptoms was 18 months and that from diagnosis was 11 months. Also, 75% survival time from diagnosis was 6 months in the smoking groups and 19 months in the non-smoking groups.
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Summary
- A Study on the Efficient Management of Long-term Inpatient Flow in a General Hospital.
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Chun Bae Kim, Young Moon Chae, Seung Hum Yu, Hee Chul Oh
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Korean J Prev Med. 1990;23(1):11-21.
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- This study refers to the problem of long-term inpatient flow in a general hospital. In this study, a queueing simulation model was developed for the two departments in the hospital with a homogenous case mix and relatively many long-term inpatients in order to increase the tumover rate and hospital charges. Before the simulation run, the model was verified by the Kolmogorov-Smirmov test. The following results were generated by three alternative models of the special bed policies. 1. Alternative I: When long term inpatients were admitted to the wards belonging to departments A and B without transfer to other departments and special beds, the average turn-over rate decreased by 2-4% and the average hospital charges decreased by 70 million won. 2. Alternative II: When long-term inpatients were transferred to department C but the transfer of wards was determined by department C in order of clinical need, the average turnover rate increased by 4-13% but the average hospital charges decreased by 30 million won. This result was not greatly different from the present state. 3. Alternative III: When long-term inpatients were transferred to the special wards and department C simultaneously, the increase in the average turnover rate and hospital charges was equivalent to the increase of two beds in the special wards. When the special wards were allocated 16 beds, the average turnover rate of departments A and B increased by about 55% and 20% respectively. Also, the hospital charges increased by about 0.44 billion won. As a result, trasfer to department C and the use of 16 beds in the special wards for long-term inpatients of departments A and B is expected to maximize the hospital revenue. However, as the above special bed policy can not increase the turnover rate above 60%, there is a need for a more comprehensive policy to further increase the rate. The development of an elaborate model should include the number of long-term inpatients in all clinical departments, the special wards system or an increase of hospital beds to handle admission needs, and the resources of the hospital by department. When the alternative are evaluated, a cost-benefit analysis in addition to the turnover rate and the hospital charges should be considered.
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Summary
- The Change of Children's Blood Pressure and Factors Affecting the Level of Blood Pressure In Children.
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Il Suh, Il Soon Kim, Chung Mo Nam, Soon Young Lee, Hee Chul Oh, Chun Bae Kim, Eun Cheol Park
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Korean J Prev Med. 1989;22(3):303-312.
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- To show the distribution and change of blood pressure according to age and find factors affecting the level of blood pressure in primary school children, a follow-up study was conducted from 1986 to 1989 on 401 first grade children attending primary school in Kangwha county in 1986 and their parents. The blood pressure of the children was significantly increased according to age. The average annual increase was 1.8mmHg in systolic blood pressure and 2.5mmHg in diastolic blood pressure. The level of blood pressure did not show any significant difference in both sexes. Among children who were at or above the 80th percentile of blood pressure in the first grade, 35 and 30% of them have remained at the same level of systolic and diastolic blood pressure respectively in the fourth grade. But we could not find any significance in the tracking of blood pressure of children who were at or above the 90th percentile of blood pressure in the first grade. Weight and pulse rate were shown to significant factors affecting systolic blood pressure in children of both sexes and mother's blood pressure and skinfolds thickness were also affected systolic blood pressure in girls. The variables significantly affecting diastolic blood pressure were arm circumference and pulse rate for boys and height and pulse rate for girls.
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Summary
- Analysis of Sports Medical Care Utilization during the 24th Seoul Olympic Games.
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Seung Hum Yu, Myongsei Sohn, Young Doo Lee, Eun Cheol Park, Chun Bae Kim
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Korean J Prev Med. 1989;22(1):136-145.
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- This study made a descriptive analysis of the cumulative amount and rate of sports medical care utilization during the 24th Seoul Olympic Games by the participating athletes, officials, etc. The sports medical care utilization was a component of the total medical care use and was basically caused by the prevention and treatment of sports injuries. The analytic data were derived from the Olympic Health Management Information System (OHMIS) of the SLOOC and the Korea Athlete Trainer Association(KATA). These were analyzed according to the., quantity of physician visits and the utilization rate, which was the amount of utilization divided by the total number of participating persons. The results were as follows: Firstly, the sports medical care utilization by the persons participating in the Seoul Olympics amounted to 17.9 % of the total medical care utilization. The venue medical services utilization accounted for 54.7 % of the total physician visits, which was larger than the village medical center's utilization. The number of physician visits per hundred persons during the 2 week period in the venue clinic was 3.03 and that of the village medical center was 2.51, therefore, the total was 5.54. Secondly, athletes accounted for 82.3% and officials 12.2% in the sports medical care utilization by participants. These results were because athletes, who were directly related to the games, called extremely often on the physicians. The utilization rate of sports medical care by athletes was 34.29. Thirdly, the sports medical demand according to type of therapy could be ranked from high to low in the following order: sports massage, thermal therapy, and electrical stimulation treatment, etc. The department of physical therapy in the village medical center was used a great deal. Fourthly, the trend of daily sports medical care utilization by the athletes showed a bell shape centering around the opening day of the Seoul Olympic Games. The utilization rate of athletes was 2.3; however, that of officials was 0.6. Lastly, the sports medical demand was calculated according to the continents, and Central America, Africa and Middle-East Asia proved to have a higher rate of sports medical care utilization than the more powerful and industrialized continent or regions.
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KSPM
