OBJECTIVE: This study analyzed the national claims data of veterans to generate scientific evidence of the trends and appropriateness of their drug utilization in an outpatient setting. METHODS: The claims data were provided by the Health Insurance Review & Assessment (HIRA). Through sampling and matching data, we selected two comparable groups; Veterans vs. National Health Insurance (NHI) patients and Veterans vs. Medical Aid (MAID) patients. Drug use and costs were compared between groups by using multivariate gamma regression models to account for the skewed distribution, and therapeutic duplication was analyzed by using multivariate logistic regression models. RESULTS: In equivalent conditions, veteran patients made fewer visits to medical institutions (0.88 vs. 1), had 1.86 times more drug use, and paid 1.4 times more drug costs than NHI patients (p < 0.05); similarly, veteran patients made fewer visits to medical institutions (0.96 vs. 1), had 1.11 times more drug use, and paid 0.95 times less drug costs than MAID patients (p < 0.05). The risk of therapeutic duplication was 1.7 times higher (OR=1.657) in veteran patients than in NHI patients and 1.3 times higher (OR=1.311) than in MAID patients (p < 0.0001). CONCLUSION: Similar patterns of drug use were found in veteran patients and MAID patients. There were greater concerns about the drug use behavior in veteran patients, with longer prescribing days and a higher rate of therapeutic duplication, than in MAID patients. Efforts should be made to measure if any inefficiency exists in veterans' drug use behavior.
Drug Costs ; Drug Utilization ; Humans ; Insurance, Health ; Logistic Models ; National Health Programs ; Outpatients* ; Prescriptions* ; Veterans*

BACKGROUND: Previous studies have revealed an association between health behavior and household type; moreover, there have been debates on the relation between drinking behavior and household type. Therefore, we examined drinking behavior of one-person households and compared the differences with multi-person households.METHODS: This study analyzed 8,966 participants, aged 19 years or older, in the 6th Korea National Health and Nutrition Examination Survey (2013, 2015). All participants were categorized into one- and multi-person households. The general characteristics were extracted using a chi-square test, and the risk of drinking behavior of one-person households was analyzed via multiple logistic regression.RESULTS: There were no statistically significant differences in the drinking behavior of men by household type. However, the risks of binge and problem drinking were 3.242 times (95% confidence interval [CI], 1.624–6.471) and 2.488 times (95% CI, 1.097–5.642) higher, respectively, in one-person household women than in multi-person household members aged between 19 and 39 years. Furthermore, the risk of problem drinking was 2.266 times (95% CI, 1.126–4.561) higher in one-person household women than in multi-person household members aged between 40 and 64 years.CONCLUSION: Considering the increasing trend of one-person households, follow-up studies on drinking behavior of one-person households are needed; the findings of these studies need to be used to prevent alcohol-related diseases and socio-economic problems.
Drinking Behavior ; Drinking ; Family Characteristics ; Female ; Follow-Up Studies ; Health Behavior ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys

The purpose of this study was to evaluate trends in the sources of dietary sodium intake in a representative Korean population in the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 1998, 2001, 2005, 2007, 2008, 2009, and 2010. The study consisted of 53,570 men and women aged 7 years or older participating in the KNHANES during the corresponding years. Overall sodium intake and the mean percent contribution of each dish and food group to dietary sodium intake across 1998-2010 were calculated. The means of sodium intake ranged between 4,572.6-5,498.9 mg/d across 1998-2010. The major dish groups contributing to dietary sodium intake were kimchi (1,154.8-1,521.2 mg/d), noodles and dumplings (505.3-760.5 mg/d), soups (465.3-714.8 mg/d), and stews and casseroles (387.0-579.8 mg/d). The combined mean percent contribution from the top four dish groups contributing to dietary sodium intake showed a slight decrease over the period; 64.4% in 1998, 64.5% in 2001, 59.3% in 2005, 58.2% in 2007, 56.3% in 2008, 56.7% in 2009, and 54.4% in 2010. The major food groups contributing to dietary sodium intake were seasonings (1,852.9-2,435.9 mg/d), vegetables (1,425.6-1,792.1 mg/d), grains (482.2-778.1 mg/d), and fish and shellfish (257.2-351.4 mg/d). In addition, the combined mean percent contribution from the top four food groups showed a slight decrease over the period; 92.8% in 1998, 93.2% in 2001, 93.8% in 2005, 92.1% in 2007, 91.7% in 2008, 90.9% in 2009, and 90.7% in 2010. In summary, we did not observe a reduction in dietary sodium intake over time, however, the percent contributions from the top major dish groups or food groups to dietary sodium intake showed a decrease over the last decade.
Aged ; Edible Grain ; Female ; Humans ; Korea ; Male ; Nutrition Surveys ; Seasons ; Shellfish ; Sodium ; Sodium, Dietary ; Vegetables

Objective: To gather the opinions of hands-on workers for successful introduction of the Development Safety Update Report (DSUR) according to a five-year comprehensive plan for clinical trial development [Ministry of Food and Drug Safety, 2019]. Methods: We conducted a survey on considerations that industry stakeholders may have related to the enforcement of the DSUR. A questionnaire was distributed among pharmacovigilance specialists from 13 pharmaceutical companies in South Korea on June 4, 2020. The questionnaire comprised two sections: 1) current status of the Drug Safety Data Management System and 2) considerations on the implementation and management of the DSUR. Results: All respondents have agreed the introduction of DSUR is inevitable for regulatory harmonization and safety of trial subject. However, most respondents (85%) felt concern about additional workload with DSUR implementation. They answered that format and operation system of DSUR should be harmonized with those of international standards and authorities need to minimize double burden due to related report. Conclusion All respondents asserted that domestic DSUR should be harmonized with International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) E2F guidelines. Respondents from global companies also suggested regulatory authorities allow DSUR written in English to replace Korean version considering their deadline for submission.Moreover, every respondent agreed regulatory authorities need delicate effort when implementing mandatory submission of DSUR to ensure that even small pharmaceutical companies with no experience in DSUR can comply with the system.

Objective: To gather the opinions of hands-on workers for successful introduction of the Development Safety Update Report (DSUR) according to a five-year comprehensive plan for clinical trial development [Ministry of Food and Drug Safety, 2019]. Methods: We conducted a survey on considerations that industry stakeholders may have related to the enforcement of the DSUR. A questionnaire was distributed among pharmacovigilance specialists from 13 pharmaceutical companies in South Korea on June 4, 2020. The questionnaire comprised two sections: 1) current status of the Drug Safety Data Management System and 2) considerations on the implementation and management of the DSUR. Results: All respondents have agreed the introduction of DSUR is inevitable for regulatory harmonization and safety of trial subject. However, most respondents (85%) felt concern about additional workload with DSUR implementation. They answered that format and operation system of DSUR should be harmonized with those of international standards and authorities need to minimize double burden due to related report. Conclusion All respondents asserted that domestic DSUR should be harmonized with International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) E2F guidelines. Respondents from global companies also suggested regulatory authorities allow DSUR written in English to replace Korean version considering their deadline for submission.Moreover, every respondent agreed regulatory authorities need delicate effort when implementing mandatory submission of DSUR to ensure that even small pharmaceutical companies with no experience in DSUR can comply with the system.

The I-gel(TM) is a single-use supraglottic airway device introduced in 2007 which features a non-inflatable cuff and allows passage of a tracheal tube owing to its large diameter and short length of the airway tube. In this case, the authors experienced a difficult airway management on a 4-year-old boy with underlying Goldenhar syndrome who underwent a tonsillectomy. Intubation using a laryngoscope was unsuccessful at the first attempt. In the following attempt, we used the I-gel(TM) supraglottic airway for ventilation and were able to achieve successful intubation with a cuffed tube by using fiberoptic bronchoscope through the I-gel(TM) supraglottic airway. The authors suggest that I-gel(TM) is a useful device for ventilation and it has many advantages for tracheal intubation in pediatric patients with difficult airway.
Airway Management ; Bronchoscopes ; Goldenhar Syndrome ; Humans ; Intubation ; Laryngeal Masks ; Laryngoscopes ; Tonsillectomy ; Ventilation

Following the implementation of a long-term care insurance system for the elderly in Korea, many nursing homes have been established and many more patients than ever before have been living at nursing homes. Despite the fact that this is a high-risk group vulnerable to hip fractures, no study has yet been conducted in Korea on hip fracture incidence rates and prognoses among patients residing at nursing homes. We recently studied 46 cases of hip fracture in nursing homes; more specifically, we investigated the most common conditions under which fractures occur, and examined the degree of recovery of ambulatory ability and the mortality within 1 yr. Among those who had survived after 1 yr, the number of non-functional ambulators increased from 8 hips before hip fracture to 19 hips at final post-fracture follow-up. These individuals showed poor recovery of ambulatory ability, and the number who died within one year was 11 (23.9%), a rate not significantly different from that among community-dwelling individuals. It was evident that hip-joint-fracture nursing home residents survived for similar periods of time as did those dwelling in the community, though under much more uncomfortable conditions. The main highlight of this report is that it is the first from Korea on nursing home residents' ambulatory recovery and one-year mortality after hip fracture. The authors believe that, beginning with the present study, the government should collect and evaluate the number of hips fractured at nursing facilities in order to formulate criteria that will help to enable all patients to select safer and better-quality nursing facilities for themselves or their family members.
Aged ; Aged, 80 and over ; Body Mass Index ; Cerebrovascular Disorders/etiology ; Dementia/etiology ; Female ; Hip Fractures/complications/*epidemiology/mortality ; Humans ; Insurance, Long-Term Care ; Kaplan-Meier Estimate ; Male ; Nursing Homes ; Odds Ratio ; Parkinson Disease/etiology ; Republic of Korea/epidemiology ; Risk Factors

We describe a case of an intrathoracic kidney combined with right congenital diaphragmatic hernia (CDH) that was diagnosed at 32 weeks of gestation. Although it has been well established that a right CDH shows a poorer outcome than a left CDH, our present case showed a good outcome because there was no herniation of other abdominal viscera, except for the right kidney. Our findings in this case indicate that impaction of the intrathoracic kidney may act as a 'shield' against further herniation of other abdominal viscera into the thoracic cavity.
Hernia, Diaphragmatic* ; Kidney* ; Pregnancy ; Thoracic Cavity ; Ultrasonography ; Viscera*

Transarterial chemoembolization (TACE) is reportedly a useful palliative treatment in patients with unresectable or recurred hepatocellular carcinoma. Post-TACE complications are common; however, acute cholecystitis after TACE is rare. We herein report a case of a 73-year-old woman who presented with emphysematous cholecystitis and pneumobilia following TACE. Computed tomography performed for evaluation of her tumor status before TACE incidentally showed gallbladder and common bile duct stones. After TACE, she complained of severe epigastric pain with a positive Murphy's sign. Computed tomography showed emphysematous cholecystitis and pneumobilia. She was successfully treated with emergent biliary stone removal by endoscopic retrograde cholangiopancreatography.
Aged ; Carcinoma, Hepatocellular ; Chemoembolization, Therapeutic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis, Acute ; Common Bile Duct ; Emphysematous Cholecystitis ; Female ; Gallbladder ; Humans ; Palliative Care

Background: Neuroinflammation plays an important role in cognitive decline and memory impairment in neurodegenerative disorders. Previously, we demonstrated that Humulus japonicus (HJ) has anti-inflammatory effects in rodent models of Alzheimer’s disease and Parkinson’s disease. The present study aimed to examine the protective potential of HJ extracts against lipopolysaccharide (LPS)-induced cognitive impairment and scopolamine-induced amnesia in mouse models. Cognitive improvement of mice was investigated by novel object recognition test. For analyzing effects on neuroinflammation, immunohistochemistry and quantitative real-time polymerase chain reaction (qRTPCR) assays were performed. Results: We found that the oral administration of HJ significantly improved cognitive dysfunction induced by LPS in a novel object recognition test. The LPS-induced activation of microglia was notably decreased by HJ treatment in the cortex and hippocampus. HJ administration with LPS also significantly increased the mRNA expression of interleukin (IL)-10 and decreased the mRNA expression of IL-12 in the parietal cortex of mice. The increased expression of LPS-induced complement C1q B chain (C1bq) and triggering receptor expressed on myeloid cells 2 (Trem2) genes was significantly suppressed by HJ treatment. In addition, HJ administration significantly improved novel object recognition in a scopolamine-induced amnesia mouse model. Conclusions These findings revealed that HJ has a beneficial effect on cognitive impairment and neuroinflammation induced by systemic inflammation and on amnesia induced by scopolamine in mice.