BACKGROUND AND OBJECTIVES: The incidence of inflammatory heart diseases is not yet as high as those of other cardiovascular diseases; however, inflammatory heart diseases do have relatively high mortality rate. Therefore, update information on the economic burden of inflammatory heart diseases are necessary in order to appropriate policy making on these diseases. MATERIALS AND METHODS: This study used a number of resources to obtain data, national health insurance statistics, the Korean Health Panel, and the causes of death report by the Korean National Statistical Office. The total costs of inflammatory heart diseases were estimated as the sum of direct medical care costs, direct non-medical care and indirect costs. RESULTS: The total direct cost of inflammatory heart disease was higher in Korean men than that of Korean women and cost due to inpatient was higher than that of outpatients cost. The costs to cover premature death were highest among all of the components used to determine the total costs for inflammatory heart disease, representing 66.3% of these costs in Korea. CONCLUSION: Inflammatory heart disease has a relatively high mortality rate, and the costs that are associated with premature deaths consume the greatest proportion of the costs associated with this disease. In spite of some limitations of study, this could be a reliable evidence of economic burden of inflammatory heart disease.
Cause of Death ; Cost of Illness ; Endocarditis ; Female ; Health Care Costs ; Heart ; Heart Diseases ; Humans ; Incidence ; Inflammation ; Inpatients ; Korea ; Male ; Mortality, Premature ; National Health Programs ; Outpatients ; Policy Making

Becker’s nevus (BN) is a benign hamartoma that may present as a distressing cosmetic problem. The treatment of BN poses a significant challenge as current therapeutic modalities are suboptimal and have an increased risk of adverse effects, such as scarring and dyspigmentation. We present the use of non-ablative fractional laser therapy combined with Q-switched Nd:YAG laser as a possible therapeutic option for BN treatment and review relevant literature to discuss its efficacy and limitations.

Background: The Baumann skin type (BST) classification provides a new approach for clinical care of dermatologic patients. Objective: To investigate the correlation of skin types with genetic factors and environmental factors that have an important influence on Korean skin by comparing and analyzing the correlation between phenotype and genotype. Methods: From July to October 2016, 774 adults who visited the one online shopping mall were subjected to skin BST questionnaire and gene single-nucleotide polymorphism (SNP) tests. Oral epithelial cells of the subjects were collected using a Genoplan DNA analysis kit, and 14 genes were analyzed by a genetic analysis agency (Genoplan Inc., Fukuoka, Japan). Results: The most abundant skin type was OSNT (oily, sensitive, non-pigmented, tight) observed in 205 participants (26.5%). Of the filaggrin (FLG) SNPs, 143 participants (18.5%) had the GG (good) SNP; 391 (50.5%), GA (normal) SNP; and 240 (31.0%), AA (poor) SNP. Among those whose FLG SNP was GG (good), 121 (84.6%) were sensitive and 22 (15.4%) were resistant. Of those whose filaggrin (FLG) SNP was GA (normal), 337 (86.2%) were sensitive and 54 (13.8%) were resistant. Of those whose FLG SNP was AA (poor), 213 (88.8%) were sensitive and 27 (11.3%) were resistant. There was also a statistically significant difference in the fruit-vegetable consumption and use of a sunbathing bed between sensitive and resistant type in the groups that classified the FLG SNP as GA. Conclusion This is the first study to investigate the association of BST with genetic factors and environmental factors.

OBJECTIVES: The incidence and survival rate of colorectal cancer in Korea are increasing because of improved screening, treatment technologies, and lifestyle changes. In this aging population, increases in economic cost result. This study was conducted to estimate the economic burden of colorectal cancer utilizing claims data from the Health Insurance Review and Assessment Service. METHODS: Economic burdens of colorectal cancer were estimated using prevalence data and patients were defined as those who received ambulatory treatment from medical institutions or who had been hospitalized due to colorectal cancer under the International Classification of Disease 10th revision codes from C18-C21. The economic burdens of colorectal cancer were calculated as direct costs and indirect costs. RESULTS: The prevalence rate (per 100 000 people) of those who were treated for colorectal cancer during 2010 was 165.48. The economic burdens of colorectal cancer in 2010 were 3 trillion and 100 billion Korean won (KRW), respectively. Direct costs included 1 trillion and 960 billion KRW (62.85%), respectively and indirect costs were 1 trillion and 160 billion (37.15%), respectively. CONCLUSIONS: Colorectal cancer has a large economic burden. Efforts should be made to reduce the economic burden of the disease through primary and secondary prevention.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Colorectal Neoplasms/*economics/epidemiology ; *Cost of Illness ; Female ; Health Care Costs ; Health Expenditures ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Republic of Korea ; Young Adult

BACKGROUND: Postoperative nausea and vomiting (PONV), postanesthetic shivering and pain are common postoperative patient complaints that can result in adverse physical and psychological outcomes. Some antiemetics are reported to be effective in the management of postoperative pain and shivering, as well as PONV. We evaluated the efficacy of dexamethasone added to ramosetron on PONV, shivering and pain after thyroid surgery. METHODS: One hundred and eight patients scheduled for thyroid surgery were randomly allocated to three different groups: the control group (group C, n = 36), the ramosetron group (group R, n = 36), or the ramosetron plus dexamethasone group (group RD, n = 36). The patients were treated intravenously with 1 and 2 ml of 0.9% NaCl (group C); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 0.9% NaCl (group R); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 5 mg/ml dexamethasone (group RD) immediately after anesthesia. RESULTS: Incidence of nausea and the need for rescue antiemetics, verbal rating scale (VRS) 1 hour pain value, ketorolac consumption, and incidence of shivering were significantly lower in group R and group RD, than in group C (P < 0.05). Moreover, these parameters were significantly lower in group RD than in group R (P < 0.05). CONCLUSIONS: Combination of ramosetron and dexamethasone significantly reduced not only the incidence of nausea and need for rescue antiemetics, but also the VRS 1 hour pain value, ketorolac consumption, and the incidence of shivering compared to ramosetron alone in patients undergoing thyroid surgery.
Anesthesia ; Antiemetics ; Dexamethasone* ; Humans ; Incidence ; Ketorolac ; Nausea ; Pain, Postoperative ; Postoperative Nausea and Vomiting* ; Shivering* ; Thyroid Gland* ; Vomiting*

OBJECTIVES: The purposes of this study were to evaluate the prevalence of epilepsy and to estimate the cost of epilepsy in Korea, 2010. METHODS: This study used a prevalence based approach to calculate the cost of epilepsy. Claims data from the Korean national health insurance and data from the Korea health panel, the Korea National Statistical Office's records of causes of death, and labor statistics were used to estimate the cost of epilepsy. Patients were defined as those who were hospitalized or visited an outpatient clinic during 2010 with a diagnosis of epilepsy (International Classification of Diseases 10th revision codes G40-G41). Total costs of epilepsy included direct medical costs, direct non-medical cost and indirect costs. RESULTS: The annual prevalence of treated epilepsy was 228 per 100 000 population, and higher in men. The age-specific prevalence was highest for teenagers. The total economic burden of epilepsy was 536 billion Korean won (KW). Indirect cost (304 billion KW) was 1.3 times greater than direct cost (232 billion KW). By gender, the male (347 billion KW) were more burdened than the female (189 billion KW). The estimated cost in young age younger than 20 years old was 24.5% of the total burden of epilepsy. CONCLUSIONS: A significant portion of the economic burden of epilepsy is borne by people in young age. To reduce the economic burden of epilepsy, effective prevention and treatment strategies are needed.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; *Cost of Illness ; Epilepsy/*economics/epidemiology ; Female ; Health Care Costs/*statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; National Health Programs/economics ; Prevalence ; Republic of Korea/epidemiology ; Young Adult

This study was carried to determine the possibility of finding motile spermatozoa and fertilization, pregnancy rate after testicular sperm extraction(TESE) with ICSI in obstructive and non-obstructive azoospermic patients. In 154 cases(132 patients), obstructive azoospermia was 77 cases and non-obstructive azoospermia was 77 cases. In obstructive azoospermia, patients generally showed normal spermatogenesis and included vas agenesis(n=8), multiple vas obstruction(n=7), epididymal obstruction (n=54). Total of 982 retrieved oocytes were obtained and 84.4% were injected. The fertilization rates with 2 PN and cleavage rate were 72.5% and 62.3%, .respectively. 30 pregnancies(38.9%) were achieved and the ongoing pregnancies were 22 cases (28.6%). In non-obstructive azoospermia, patients showed hypospermatogenesis(n=49), maturation arrest(n=4), Sertoli cell only syndrome (n=24). The various stages of spermatogenic cell could be retrieved by TESE and could be reached normal fertilization and embryo development with ICSI. Total of 1072 retrieved oocytes obtained and 80.2% were injected. The fertilization rates with 2 PN and cleavage rate were 52.8% and 68.9%, respectively. 22 pregnancies(30.1%) were achieved and the ongoing pregnancies were 19 cases(26.0%). Conclusively, the combination of TESE with ICSI using testicular spermatozoa can achieve normal fertilization and pregnancy rate and effective method in obstructive and non-obstructive azoospermic patients.
Azoospermia ; Embryonic Development ; Female ; Fertilization* ; Humans ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Spermatogenesis ; Spermatozoa*

BACKGROUND: Electroconvulsive therapy (ECT) is effective for major psychosis and affective disorder. The ideal anesthetics for ECT provide rapid induction and recovery, and they attenuate the adverse effects of ECT. We compared the effects of etomidate, propofol and thiopental sodium during ECT. METHODS: Nine patients were enrolled in this double blinded cross over design study. The ECT was done 3 times per week for two weeks. We monitored the patients with electrocardiography, pulse oximetry, the bispectral index score and the blood pressure. We recorded the data at the time of arrival to the therapy room, just before ECT and at 1, 2, 3, 4, 5, 7 and 10 minutes after ECT. Hypnosis was induced with 3 mg/kg of thiopental sodium (group T), 1.5 mg/kg of propofol (group P) or 0.15 mg/kg of etomidate (group E). The ECT was done after administering 1 mg/kg of succinylcholine. The duration of seizure were measured after ECT. RESULTS: There were significantly different durations of motor seizure among the three groups. The duration of EEG seizure in group E was longer than that of group P and group T. The blood pressure and the heart rate of group P were significantly lower than that of the other groups (P < 0.05). CONCLUSIONS: Compared to thiopental sodium and etomidate, propofol was not associated with clinically significant changes in the duration of seizure and hemodynamic stability. It has a good hypnotic effect and it did not affect the therapeutic efficacy of ECT. Etomidate is effective for patients for achieving a short duration of seizure after ECT is applied.
Anesthetics ; Blood Pressure ; Cross-Over Studies ; Electrocardiography ; Electroconvulsive Therapy ; Electroencephalography ; Etomidate ; Heart Rate ; Hemodynamics ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Mood Disorders ; Oximetry ; Propofol ; Psychotic Disorders ; Seizures ; Succinylcholine ; Thiopental

Stroke is a disease that causes a substantial economic burden. With the rapidly aging population in Korea, the prevalence of chronic diseases, including stroke, is expected to rise, along with associated health care expenditures. Therefore, we estimated the economic burden of stroke in Korea in 2010 using nationally representative data. We used a prevalence-based approach to estimate the cost of stroke by claims data from the Korean National Health Insurance. Data from the Korea Health Panel, the Korea National Statistical Office's records of causes of death, and Labor Statistics were used to calculate direct non-medical costs and indirect costs. Direct costs included direct medical costs and direct non-medical costs, and indirect costs were opportunity costs lost due to premature death and productivity loss. Total costs were estimated by adding age- and gender-specific costs. The total economic burden of stroke was $3.53 billion: $1.87 billion for hemorrhagic stroke and $1.66 billion for ischemic stroke. The direct costs were $1.74 billion and the indirect costs were $1.79 billion. By gender, males were burdened at $2.19 billion, while females bore $1.34 billion of the total burden. Stroke imposes a huge economic burden, as indicated by the fact that the costs of stroke increased by 4.4% from 2005 to 2010, and the estimated cost was 0.35% of gross domestic product. Therefore, effective prevention programs and treatments are needed to reduce the economic burden of stroke in Korea.
Aging ; Cause of Death ; Chronic Disease ; Cost of Illness ; Delivery of Health Care ; Efficiency ; Female ; Gross Domestic Product ; Health Expenditures ; Humans ; Korea ; Male ; Mortality, Premature ; National Health Programs ; Prevalence ; Stroke

BACKGROUND: Descriptive diagnosis reports have been causing some problems in communication. Our institution decided to use the category diagnosis system since June, 2008. So we evaluated the effectiveness of this change. METHODS: The category system is composed of unsatisfactory, suboptimal for diagnosis but suggestive of, most probably benign, indeterminate, suspicious for malignancy and malignancy. We evaluated 1,525 cases from June, 2008 to September, 2009. We analyzed 159 cases of the indeterminate category. RESULTS: Among the 159 cases, 21 were re-aspirated and 63 underwent an operation. The diagnoses of the re-aspirated cases were 2 positive for malignancy, 5 indeterminate, 13 most probably benign, and 1 unsatisfactory. The surgical diagnoses were 39 malignancies, 2 follicular adenomas and 1 Hurthle cell adenoma, and 21 benign lesions. Re-aspiration for the indeterminate cases could help decide whether the lesions need to be operated or not at above 70%. The indeterminate category could predict the surgical diagnosis of the thyroid nodule with statistical significance when the subcategories were indicated (p < 0.001). CONCLUSIONS: The category diagnosis is replacing the descriptive diagnosis for the thyroid fine needle aspiration. The indeterminate category is useful and effective for making the decision to operate and especially when the indeterminate subcategories are used.
Adenoma ; Biopsy, Fine-Needle ; Thyroid Gland ; Thyroid Nodule