Purpose: We explored the role of parental social class in preterm birth (PTB) and low birth weight (LBW) in association with child mortality in Korea. Materials and Methods: A total of 7,302,732 births in Korea between 1995 and 2007 were used for designing the national retrospective cohort study. Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the risk of child death after adjusting for covariates. Results: Parental social class was associated with adverse birth outcomes and child mortality in Korea. Parental social class increased the strength of the relationship of adverse birth outcomes with child mortality. Child mortality was higher among PTB and LBW infants from parents with a lower social class than normal births from parents with a higher social class. In particular, the disparity in child mortality according to parental social class was greater for LBW and PTB than intrauterine growth retardation births.When one of the parents had a middle-school education or lower, the disparity in child mortality due to adverse birth outcomes was large regardless of the other spouse’s educational status. Inactive economic status for the father, as well as an occupation in manual labor by the mother, increased the risk of child mortality. Conclusion Strong relationships for social inequalities and adverse birth outcomes with inequalities in child mortality in South Korea were found in this study. Tackling social inequalities, as well as reducing adverse birth outcomes, are needed to reduce the disparities in child mortality in South Korea.

Background: To investigate the effect of parental social class on cancer mortality in children under 5 in Korea, two birth cohorts were constructed by linking national birth data to under-5 death data from the Statistics Korea for 1995–1999 (3,323,613 births) and 2010–2014 (2,297,876 births). Methods: The Cox proportional hazards model adjusted for covariates was used in this study. Results: Social inequalities of under-5 cancer mortality risk in paternal education and paternal employment status were greater in 2010–2014 than in 1995–1999. The gap of hazard ratio (HR) of under-5 cancer mortality between lower (high school or below) and higher (university or higher) paternal education increased from 1.23 (95% confidence interval, 1.041.46) in 1995–1999 to 1.45 (1.11–1.97) in 2010–2014; the gap of HR between parents engaged in manual work and non-manual work increased from 1.32 (1.12–1.56) in 1995–1999 to 1.45 (1.12–1.89) in 2010–2014 for fathers, and from 1.18 (0.7–1.98) to 1.69 (1.03–2.79) for mothers. When the parental social class was lower, the risk of under-5 cancer mortality was higher in not only adverse but normal births. Conclusion Social inequalities must be addressed to reduce the disparity in cancer mortality of children under 5 years old.

PURPOSE: This study aimed to evaluate the situations and problems of the current health insurance fees for trauma surgeries. METHODS: We reviewed the medical records and billing data from trauma surgeries performed in the hospital from August 2012 to July 2014. The name and number of surgeries were investigated and the code and number of operations prescribed by surgeons were compared with the number of cases actually billed to insurance. In addition, the results returned by the Health Insurance Review & Assessment Services (HIRA) after deduction were investigated and compared to verify the insurance review findings. RESULTS: During the study period, total 1,534 trauma surgical procedures were performed for a total of 253 trauma patients. Based on names, 1,092 procedures were performed; however, 442 cases (28.8%) could not be prescribed because of lack of proper insurance codes for the procedures. A total of 1,046.5 surgical procedures were prescribed by surgeons, adjusted by the insurance team, and finally billed to the HIRA; 162 bills were returned from the HIRA after rate reductions, corresponding to a reduction rate of 15.5%. The major reason for reduction was “fee criteria and limited number”. The compensation rate for billed surgical procedures was 84.5%. CONCLUSION: The high reduction and low compensation rate for trauma surgery under the current Korean National Health Insurance System need to be reviewed and improved. Furthermore, it is necessary to establish new criteria for surgical procedures fees for latest ones such as damage control surgery performed on severe trauma patients.
Compensation and Redress* ; Fees and Charges ; Humans ; Insurance ; Insurance, Health ; Korea ; Medical Records ; National Health Programs* ; Surgeons ; Surgical Procedures, Operative ; Wounds and Injuries

BACKGROUND: As an endemic area of viral hepatitis B, many studies on hepatitis B and C have been reported in Korea, but no on all five viral types, A, B, C, D, and E. We surveyed ten serologic markers for the five different viral hepatitis and reviewed the seropositivity of each viral hepatitis and concurrent infection. METHODS: Ten serologic markers of five viral hepatitis (anti-HAV IgM, anti-HAV IgG, HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe, anti-HCV, anti-HDV, and anti-HEV IgM) were tested for 260,488 samples requested for viral marker studies at three hospitals of Korea University Medical Centers from January through December, 2003. Anti-HAV IgM, anti-HAV IgG, anti-HDV, and anti-HEV IgM were tested by RIA and HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe, and anti-HCV were analysed by ELISA or RIA method. RESULTS: Anti-HAV IgM and IgG seropositivity was 1.2% and 88.0%, respectively. Anti-HAV IgM seropositivity was high in a patient group 20 to 29 years of age. The overall seropositivity of HBsAg was 10.4% and for anti-HBs 60.4%. The seropositivity was 1.3% for anti-HCV, 1.1% for anti-HDV, and 22.2% for anti-HEV IgM. The concurrent positivity of HBsAg and anti-HBs was 4.0%. HBsAg was positive in 7 (0.1%) of anti-HCV positive patients; anti-HEV IgM was positive in 2 (25%) of anti-HAV IgM positive patients. CONCLUSIONS: Hepatitis A infection was rare in children but increased in patient group 20 to 29 years of age. The concurrent infection rate of hepatitis A with hepatitis E was high, suggesting that hepatitis E should be considered in hepatitis A patients. In view of the finding that the concurrent infection of hepatis B and C was detected, though at a relatively low rate, patients with viral hepatitis need to be assessed for the possibility of concurrent infection with other types of hepatitis.
Academic Medical Centers* ; Biomarkers ; Child ; Coinfection ; Enzyme-Linked Immunosorbent Assay ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis E ; Hepatitis* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Korea

PURPOSE: The objective of this study was to assess attenuation correction algorithms with the 137Cs point source for the brain positron emission tomography (PET) imaging process. MATERIALS AND METHODS: Four different types of phantoms were used in this study for testing various types of the attenuation correction techniques. Transmission data of a 137Cs point source were acquired after infusing the emission source into phantoms and then the emission data were subsequently acquired in 3D acquisition mode. Scatter corrections were performed with a background tail-fitting algorithm. Emission data were then reconstructed using iterative reconstruction method with a measured (MAC), elliptical (ELAC), segmented (SAC) and remapping (RAC) attenuation correction, respectively. Reconstructed images were then both qualitatively and quantitatively assessed. In addition, reconstructed images of a normal subject were assessed by nuclear medicine physicians. Subtracted images were also compared. RESULTS: ELAC, SAC, and RAC provided a uniform phantom image with less noise for a cylindrical phantom. In contrast, a decrease in intensity at the central portion of the attenuation map was noticed at the result of the MAC. Reconstructed images of Jaszack and Hoffan phantoms presented better quality with RAC and SAC. The attenuation of a skull on images of the normal subject was clearly noticed and the attenuation correction without considering the attenuation of the skull resulted in artificial defects on images of the brain. CONCLUSION: the complicated and improved attenuation correction methods were needed to obtain the better accuracy of the quantitative brain PET images.
Brain ; Noise ; Nuclear Medicine ; Positron-Emission Tomography ; Skull

PURPOSE: To obtain basic information for studies of male sexual dysfunction, we investigated the prevalence and the risk factors of erectile dysfunction(ED) in Korean young men via an Internet survey. MATERIALS AND METHODS: In June 2006, 23594 subjects aged from 20 to 59, who had registered with an internet research company, were asked to join our study if they had had stable sexual activities more than once a month for the past 6 months. Questions covered demographic characteristics, sexual life, International Index of Erectile Function(IIEF), and International Prostatic Symptom Score(IPSS). RESULTS: A total of 601 subjects completed the questionnaires. The prevalence of self-reported ED was 6.7%. The proportion of men with self-reported ED was 3.7% in the 20-29 age group, 6.0% in the 30-39 age group, and 9.5% in the 40-49 age group. The overall prevalence of ED assessed by IIEF-EF domain score of < or = 25 was 41.0%. We found a statistically significant correlation between men with self-reported ED and lower IIEF-EF domain scores. Self-reported ED was significantly associated with aging, smoking, lower education, and lower urinary tract symptoms (LUTS). Lower IIEF-EF domain scores were correlated with higher IPSS total, voiding and storage scores. CONCLUSIONS: ED in Korean young men is common and closely associated with LUTS. An Internet survey requires less man power, less time, and less research funds than classical survey methods such as mail or interview surveys. These study results will be useful as basic data for future studies of young Korean men's sexual function
Aging ; Surveys and Questionnaires ; Education ; Erectile Dysfunction* ; Financial Management ; Humans ; Internet ; Lower Urinary Tract Symptoms ; Male ; Multiple Endocrine Neoplasia Type 1 ; Postal Service ; Prevalence* ; Risk Factors* ; Sexual Behavior ; Smoke ; Smoking

PURPOSE: To obtain basic information for studies of male sexual dysfunction, we investigated the prevalence and the risk factors of erectile dysfunction(ED) in Korean young men via an Internet survey. MATERIALS AND METHODS: In June 2006, 23594 subjects aged from 20 to 59, who had registered with an internet research company, were asked to join our study if they had had stable sexual activities more than once a month for the past 6 months. Questions covered demographic characteristics, sexual life, International Index of Erectile Function(IIEF), and International Prostatic Symptom Score(IPSS). RESULTS: A total of 601 subjects completed the questionnaires. The prevalence of self-reported ED was 6.7%. The proportion of men with self-reported ED was 3.7% in the 20-29 age group, 6.0% in the 30-39 age group, and 9.5% in the 40-49 age group. The overall prevalence of ED assessed by IIEF-EF domain score of < or = 25 was 41.0%. We found a statistically significant correlation between men with self-reported ED and lower IIEF-EF domain scores. Self-reported ED was significantly associated with aging, smoking, lower education, and lower urinary tract symptoms (LUTS). Lower IIEF-EF domain scores were correlated with higher IPSS total, voiding and storage scores. CONCLUSIONS: ED in Korean young men is common and closely associated with LUTS. An Internet survey requires less man power, less time, and less research funds than classical survey methods such as mail or interview surveys. These study results will be useful as basic data for future studies of young Korean men's sexual function
Aging ; Surveys and Questionnaires ; Education ; Erectile Dysfunction* ; Financial Management ; Humans ; Internet ; Lower Urinary Tract Symptoms ; Male ; Multiple Endocrine Neoplasia Type 1 ; Postal Service ; Prevalence* ; Risk Factors* ; Sexual Behavior ; Smoke ; Smoking

PURPOSE: In order to obtain better quantitation of kidney uptake, this study is to evaluate a conjugate view method (CVM) using a geometric mean attenuation correction for kidney uptake and to compare it to Gate's method. MATERIALS AND METHODS: We used a Monte Carlo code, SIMIND and a Zubal phantom, to simulate kidney uptake. SIMIND was both simulated with or without scatter for the Zubal phantom. Also, a real phantom test was carried out using a dual-head gamma camera. The activity of 0.5 mCi was infused into two small cylinder phantoms of 5 cm diameter, and then, they were inserted into a cylinder phantom of 20 cm diameter. The results by the CVM method were compared with ideal data without both of attenuation and scatter and with Gate's method. The CVM was performed with or without scatter correction. The Gate's method was performed without scatter correction and it was evaluated with regards to 0.12 cm (-1) and 0.15 cm (-1) attenuation coefficients. Data were analyzed with comparisons of mean counts in the regions of interest (ROI), profiles drawn over kidney images and linear regression. Correlation coefficients were calculated with ideal data, as well. RESULTS: In the case of the computer simulation, mean counts measured from ideal data, the CVM and the Gate's method were (right: 998 +/- 209, left: 896 +/- 249), (right: 911 +/- 207, left: 815 +/- 265), and (right: 1065 +/- 267, left: 1546 +/- 267), respectively. The ideal data showed good correlation with the CVM and the correlation coefficients of the CVM, Gate's method were (right: 0.91, left: 0.93) and (right: 0.85, left: 0.90), respectively. CONCLUSION: The conjugate view method using geometric mean attenuation correction resulted in better accuracy than the Gate's method. In conclusion, the conjugate view method independent of renal depths may provide more accurate kidney uptake.
Computer Simulation ; Gamma Cameras ; Kidney* ; Linear Models