PURPOSE: The purpose of this study was to estimate the socioeconomic costs of glaucoma in Korea. It is to be used as an academic reference regarding policy making for the introduction of glaucoma screening tests in the national health check-ups. METHODS: We estimated the socioeconomic costs of glaucoma from a societal perspective, which included medical, nonmedical, and productivity costs. The medical costs consisted of official and nonofficial medical costs, and the nonmedical costs consisted of transportation, time, and nursing costs. We used the National Health Insurance Service-National Sample Cohort 2002–2013 and the Korea Health Panel study. RESULTS: The socioeconomic costs of glaucoma were estimated to be 3,000 billion Korean won (KRW) in 2013. These total costs were divided into 1,539 billion KRW (51.3%) for medical costs, 1,292 billion KRW (43.1%) for nonmedical costs, and 168 billion KRW (5.6%) for productivity costs. CONCLUSIONS: Glaucoma is a large economic burden from a societal perspective. The nonmedical and productivity costs, as well as the medical costs are especially high. Because the disease costs of glaucoma are expected to increase continuously, political support for early detection of glaucoma should be considered.
Cohort Studies ; Cost of Illness ; Efficiency ; Glaucoma ; Korea ; Mass Screening ; National Health Programs ; Nursing ; Policy Making ; Transportation

PURPOSE: To estimate the annual socioeconomic costs of age-related macular degeneration (AMD) in the Republic of Korea. METHODS: We estimated the costs of illness to society of AMD patients, including medical, nonmedical, and productivity costs. The medical costs included official and nonofficial medical costs, and the nonmedical costs consisted of transportation, time, and nursing costs. We used Korea National Health Insurance Claims Database, National Health Insurance Service-National Sample Cohort, and Korea Health Panel study data in the analysis. RESULTS: The socioeconomic costs of AMD were estimated to be 694 billion Korean won (KRW) in 2016. This figure was divided into 501 billion KRW (72.1%) for medical costs, 61 billion KRW (8.8%) for nonmedical costs, and 133 billion KRW (19.1%) for productivity costs. The annual per capita socioeconomic cost of AMD was 1.32 million KRW. CONCLUSIONS: We determined the scale and composition of the socioeconomic costs of AMD. Importantly, the productivity costs accounted for approximately 20% of all costs, suggesting that AMD had a significant impact on productivity. Because the disease costs of AMD are expected to increase continuously with the aging population, effective planning at the governmental level for prevention and treatment of AMD should be considered to reduce socioeconomic costs.
Aging ; Cohort Studies ; Cost of Illness ; Efficiency ; Humans ; Korea ; Macular Degeneration ; National Health Programs ; Nursing ; Republic of Korea ; Transportation

Objectives: ：An increasing number of people are affected by sleep problems every year. The current study presents findings from experiments that utilize a mobile application-based cognitive-behavioral treatment for insomnia (CBT-I). Methods: ：Our application aims to alleviate insomnia symptoms by providing real-time and direct interventions in people’s daily lives. We recruited 50 participants to test the effectiveness of the app via a six-week-long prospective experiment. Results: ：We find that insomnia symptoms are reduced significantly for both the treatment group, who used the app, and the control group, who watched educational videos [F(2,39)=60.82, p<0.001]. Sleep efficiency improved more quickly in the treatment group than in the control group. Participants who followed higher compliance to the intervention reduced their wake after sleep onset (WASO) time more substantially. Conclusion ：Our results suggest that app-based CBT-I interventions may have additional benefits for enhancing objective sleep quality, including sleep efficiency or WASO, compared to sleep hygiene education. The preliminary findings of the current research shed light on future mobile intervention apps’ design choices for insomnia.

Noncompaction of the ventricular myocardium is a rare congenital cardiomyopathy caused by arrest of normal endomyocardial embryogenesis. Isolated right ventricular noncompaction (IRNC) is an even rarer form of this disease. We report herein on a 68 year-old male diagnosed with IRNC who presented with right-sided heart failure, without involvement of the left ventricle. Diagnosis was achieved with the aid of echocardiography and ventriculography. Medical treatment including prescription of diuretics, a calcium channel blocker, and digitalis, improved both the symptoms and right ventricular function.
Calcium Channels ; Cardiomyopathies ; Diagnosis ; Digitalis ; Diuretics ; Echocardiography ; Embryonic Development ; Female ; Heart Failure ; Heart Ventricles ; Humans ; Male ; Myocardium ; Pregnancy ; Prescriptions ; Ventricular Function, Right

OBJECTIVE: This study aims to reveal the relationship of depression with growth factors such as brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and insulin-like growth factor-1 (IGF-1) in inpatients diagnosed with alcohol dependence, and to identify candidate growth factors as biological markers to indicate the comorbid of alcohol dependence and depression. METHODS: This study examined demographic factors in 45 alcohol-dependent patients. The ADS (Korean version of the Alcohol Dependence Scale) and BDI (Korean version of Beck's Depression Inventory) were used. BDNF, NGF, and IGF-1 were measured through ELISA. RESULTS: The average drinking quantity and the ADS score were significantly more severe in alcohol-dependent patients with depression than in those without depression. Linearly comparing BDNF, NGF, and IGF-1 with BDI values, IGF-1 was the growth factor significantly correlated with BDI scores. BDI scores were significantly correlated with ADS scores. IGF-1 was significantly higher in alcohol-dependent patients with depression. Alcohol-dependent patients with depression had greater alcohol use and more severe ADS scores. BDNF and NGF showed no significant difference between alcohol-dependent patients with and without depression, but IGF-1 was significantly higher in those with than in those without depression. CONCLUSION: IGF-1 was found to be associated with depression in alcohol-dependent patients, suggesting that IGF-1 in alcohol-dependent patients could be an important biomarker to indicate whether alcohol-dependence is accompanied by depression.
Alcoholism ; Biomarkers ; Brain-Derived Neurotrophic Factor ; Demography ; Depression* ; Drinking ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inpatients ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Nerve Growth Factor

PURPOSE: To evaluate the oncologic outcomes of robot-assisted radical prostatectomy (RARP) in high-risk prostate cancer (PCa), we compared the surgical margin status and biochemical recurrence-free survival (BCRFS) rates between retropubic radical prostatectomy (RRP) and RARP. MATERIALS AND METHODS: A comparative analysis was conducted of high-risk PCa patients who underwent RRP or RARP by a single surgeon from 2007 to 2013. High-risk PCa was defined as clinical stage> or =T3a, biopsy Gleason score 8-10, or prostate-specific antigen>20 ng/mL. Propensity score matching was performed to minimize selection bias, and all possible preoperative and postoperative confounders were matched. A Kaplan-Meier analysis was performed to assess the 5-year BCRFS, and Cox regression models were used to evaluate the effect of the surgical approach on biochemical recurrence. RESULTS: A total of 356 high-risk PCa patients (106 [29.8%] RRP and 250 [70.2%] RARP) were included in the final cohort analyzed. Before adjustment, the mean percentage of positive cores on biopsy and pathologic stage were poorer for RRP versus RARP (p=0.036 vs. p=0.054, respectively). The unadjusted 5-year BCRFS rates were better for RARP than for RRP (RRP vs. RARP: 48.1% vs. 64.4%, p=0.021). After adjustment for preoperative variables, the 5-year BCRFS rates were similar between RRP and RARP patients (48.5% vs. 59.6%, p=0.131). The surgical approach did not predict biochemical recurrence in multivariate analysis. CONCLUSIONS: Five-year BCRFS rates of RARP are comparable to RRP in high-risk PCa. RARP is a feasible treatment option for high-risk PCa.
Aged ; Databases, Factual ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prostatectomy/*methods ; Prostatic Neoplasms/pathology/*surgery ; Robotic Surgical Procedures/*methods ; Treatment Outcome

PURPOSE: To evaluate the clinical features and biochemical recurrence (BCR) in prostate cancer (PCa) with high-grade prostatic intraepithelial neoplasia (HGPIN). MATERIALS AND METHODS: We retrospectively analyzed the medical records of 893 patients who underwent a radical prostatectomy for PCa between 2011 and 2012 at Asan Medical Center; 752 of these patients who did not receive neoadjuvant or adjuvant therapy and were followed up for more than 1 year were included. The cohort was divided into two groups-patients with and without HGPIN-and their characteristics were compared. The Cox proportional hazards model was used to analyze factors affecting BCR. RESULTS: In total, 652 study patients (86.7%) had HGPIN. There were no significant differences in preoperative factors between the two groups, including age (p=0.369) and preoperative prostate-specific antigen concentration (p=0.234). Patients with HGPIN had a higher Gleason score (p=0.012), more frequent multiple tumor (p=0.013), and more perineural invasion (p=0.012), but no other postoperative pathologic characteristics were significantly different between the two groups. There were no significant differences in BCR (13.0% vs. 11.5%, p=0.665) and HGPIN was not associated with BCR (p=0.745). In multivariate analysis, only the T stage (p<0.001) was associated with BCR. CONCLUSIONS: PCa patients with HGPIN have a higher Gleason score, more frequent multiple tumors, and more perineural invasion than those without HGPIN. The presence of HGPIN is not an independent predictor of BCR.
Aged ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Peripheral Nerves/pathology ; Prognosis ; Prostatectomy ; Prostatic Intraepithelial Neoplasia/*pathology/surgery ; Prostatic Neoplasms/*pathology/surgery ; Recurrence ; Retrospective Studies

This practice parameter for non-pharmacological treatment for attention-deficit hyperactivity disorder(ADHD) review the domestic and international literature on the psychosocial treatment of children and adolescents with ADHD. This parameter include the parental training & education, cognitive behavior therapy(group or individual), social skill training, family therapy, play therapy(individual psychotherapy) and non-traditional therapy(art therapy, herbal therapy et al). Among them, there is some proven evidence only in parental training & education and cognitive behavior therapy. So, this parameter describes some details only in the field of parental training & education and cognitive behavior therapy. The efficacy or effectiveness, especially, cost-effectiveness of specific psychosocial treatment method for ADHD cannot be fairly assessed due to the scarcity of controlled clinical data. Based on the clinical expert consensus and limited evidence, we cautiously suggest the practice recommendations about the non-pharmacological psychosocial treatment for children and adolescents with ADHD.
Adolescent ; Child ; Cognitive Therapy ; Consensus ; Education ; Family Therapy ; Humans ; Parents ; Phytotherapy

The objective of this review is to propose the Korean practice guideline for pharmacological treatment of attentiondeficit hyperactivity disorder(ADHD). For making the guideline, the authors used the evidence-base approaches derived from a detailed review of literature including wide range of controlled clinical trials, studies of side effects of drugs, toxicological reports, and meta-analyses published in United States and Europe, as well as inside Korea. The review committee composed of experts in ADHD in Korea has reviewed the parameter. The practice parameter for pharmacological treatment describes the use of stimulants, atomoxetine, modafinil, bupropion, tricyclic antidepressants, and alpha-adrenergic agonists and their side effects. The recommendations of pharmacological treatment are proposed at the end of the article.
Adrenergic alpha-Agonists ; Advisory Committees ; Antidepressive Agents, Tricyclic ; Bupropion ; Europe ; Korea ; United States ; Atomoxetine Hydrochloride

Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder(ADHD) are the clinical interview, the medical examination, and the completion and scoring of behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or learning disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.
Adolescent ; Anxiety Disorders ; Autistic Disorder ; Child ; Diagnosis* ; Humans ; Intellectual Disability ; Korea ; Learning Disorders ; Mass Screening ; Mental Disorders ; Mood Disorders ; Psychological Tests ; Weights and Measures