Approach to Hyperamylasemia and Hyperlipasemia / 대한췌담도학회지

Hyperamylasemia and hyperlipidemia occur when the amounts of amylase and lipase that enter the blood overweigh the kidney and liver reticuloendothelial system clearance of the enzymes. In normal homeostasis, most of these enzymes are excreted from the apical membrane of the acinar cells into the ductal system of the gland. However, in pathological conditions, this apical exocytosis is blocked, and the leakage of these enzymes at the basolateral membrane is increased. Therefore, these enzymes are released into the bloodstream. Many different pancreatic pathologies and Gullo syndrome can cause this type of leakage in the pancreas. This mechanism can also cause basolateral leakage in other organs that secrete amylase and lipase. In small bowel inflammatory conditions, amylase and lipase are absorbed through the inflamed mucosa and introduced into the bloodstream due to increased vascular permeability. Regardless of the enzymes that enter the blood circulation, several kidney and liver diseases prevent the excretion and metabolism of serum amylase and lipase. When the amylase and lipase are combined with immunoglobulins, they escape normal glomerular filtration due to the development of macroenzymes and accumulate in the blood. These situations related to the clearance of the enzymes are also crucial mechanisms of serum enzyme elevation that should not be overlooked.

Socioeconomic Costs of Alcohol Drinking in Korea

BACKGROUND: The purpose of this study was to estimate socioeconomic costs caused by alcohol drinking in Korea as of 2004 in an effort to raise the awareness of the gravity of problems associated with alcohol drinking and the necessity of active intervention by family physicians. METHODS: The costs were classified as direct costs, indirect costs and other costs. The direct costs consisted of direct medical costs and direct non-medical costs. The indirect costs were computed by the reduction and loss of productivity and the loss of workforce. Other costs consisted of property loss, administration costs and costs of alcohol beverage. RESULTS: The annual costs, which seemed to be attributable to alcohol drinking, were estimated to be 200,990 hundred million won (2.9% of GDP). In the case of the former, the amount included 38.83% for reduction of productivity, 26.92% for loss of the workforce, 22.24% for alcoholic beverage, 5.34% for direct medical costs, 2.29% for loss of productivity, 1.87% for direct non- medical costs, 1.54% for administration costs and 0.97% for loss of property. CONCLUSION: Our study confirms that compared with the cases of Japan (1.9% of GNP), Canada (1.09% of GDP), France (1.42% of GDP) and Scotland (1.19% of GDP), alcohol drinking incurs substantial socioeconomic costs to Koreans. An active intervention by family physicians is suggested.

Impact of Laser in Situ Keratomileusis (LASIK) Treatment on Quality of Life in Myopia Patients

PURPOSE: To evaluate the impact of LASIK on vision-related quality of life (QOL) in myopia patients METHODS: This study included 288 patients who received laser in situ keratomileusis (LASIK) between July and December 2001 from two eye clinics located in Seoul and Pusan. Myopia-specific Quality of Life Questionnaire (MQLQ) was developed. MQLQ contained 34 questions in 4 domains that assess the effect of LASIK on visual function, visual symptoms, social and role function, and psychological well-being. Baseline QOL for the condition that refractive error was corrected by glasses or contact lenses before undergoing LASIK were evaluated by means of self-administered questionnaire. The evaluation was repeated at 4 days, 1 month, 3 months, and 6 months after LASIK. All question items were rated on a scale ranging from 1 (maximal dysfuntion) to 5 (no dysfunction). RESULTS: Average score for the MQLQ changed from 3.20 preoperatively to 3.76, 3.99, 4.07, and 4.11 at 4 days, 1 month, 3 months, and 6 months after surgery, indicating a continuous improvement of overall QOL following LASIK. Among the 4 dimensions, social and role function showed the biggest improvement (changes in score: 1.48, p=0.001), followed by psychological well-being(0.98, p=0.001), visual function(0.67. p=0.001), and visual symptoms (0.49, p=0.001). CONCLUSIONS: LASIK has a significant contribution to improve QOL in myopia patients.

Information Searching Behavior of Health Care Consumers by Sociodemographic Characteristics / 예방의학회지

OBJECTIVES: To investigate the information searching behavior of health care consumers according to sociodemographic characteristics. METHODS: A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling of the Republic of Korea, excluding the province of Jeju-do. Personal were conducted through a door-to-door survey between 27 July and 10 August 1999. RESULTS: 80.5% of respondents used more than one source of information and those 40~59 years of age, female, a housewife or student and those who claimed a religion demonstrated more active information searching behavior. A personal informer was used significantly more in those 20~39 years old, female, and those who claimed a religion. Clerical workers, those with post-secondary education and a monthly income greater than 2,000,000 won ($1500) were more actively used a public informer. Low socioeconomic status and older persons used an experimental informer when they chose a health care institution. CONCLUSION: Regardless of the sociodemographic characteristics, personal and experimental informers were the most useful source of information. Because appropriate information was not easy to obtain, the health care consumer was dependent upon word-of-mouth communication(personal informer) when using health care services.

Factors Related to Self-Perceived Health of Young Adults / 예방의학회지

OBJECTIVES: To determine which factors are related to young adults perception of their health. Two research questions were asked. Which aspects of health does self-perceived health as a index of general health reflect? Why do two individuals with the same level of general health have different health perceptions? METHODS: The sampling frame comprised college or graduate school students, aged 20 to 29, who were members of A, one of the 4 biggest internet communication services. The questionnaires were sent to study samples(n= 1,000) and answered by E-mail. Response rate was 37.0%. RESULTS: Firstly, physical health ranked highest and self-perceived health ranked lowest. Secondly, health, anxiety, depression, and self-perceived health showed significant differences between the sexes, with women showing a higher health status in these categories except for self-perceived health. Thirdly, the two factors significantly related to self-perceived health were physical health and self-esteem, as determined by multivariate analysis. CONCLUSIONS: The factors significantly related to self-perceived health were physical health and self-esteem. Further studies of the health characteristics of young adults are needed.

The Relationship of Organizational Culture and Organizational Effectiveness at the General Hospital / 예방의학회지

OBJECTIVES: Organizational culture has been important in field of organizational behavior research for the past decade. Although there has been a growing interest in the organizational culture and organizational effectiveness, there is few research in health care field. This study was carried out to investigate the relationship of organizational culture and organizational effectiveness at general hospital. METHODS: Data was collected by self-administrated questionares. Organizational cultures were measured by using Likert scale. A general hospital in Kyunggi-Do was selected and survey was conducted to 675 workers. Data was analyzed with computer package, PC- SPSS. RESULTS: There were four types of organizational culture in this hospital : consensual culture, developmental culture, hierarchical culture, rational culture. Many workers recognized their culture as rational culture and developmental culture. This finding showed that the hospital had both human related and task related climate. There were some differences in recognition of sub-organizational culture by occupational group, but perceived organizational culture was in accordance with sub-organizational culture in general. Multiple regression analysis and multiple logistic regression analysis were conducted to find the relationship of organizational culture and organizational effectiveness. As a result, developmental culture showed a strong relationship with organizational commitment and job-satisfaction. CONCLUSIONS: These results showed that types of organizational culture were significantly related to organizational effectiveness and understanding the existing culture is essential to develope their organizational effectiveness.

A study on the Statistical Distribution and Testing of Variation Indicies at the Small Area Variation Analysis / 예방의학회지

OBJECTIVES: The Study of Small Area Variation(SAV) is most interesting issue in the health care researches. Most studies of SAV have been concluded the existences of variation on the basis of the magnitude of variation without statistical testing. But it is difficult to explain the existence of variation with this way because variation indicies are easily influenced by several parameters and also their distribution are skewed. So, it needs for the study to investigate the distribution of these indices and develop the statistical testing model. METHODS: This study was planned to analyze on the distribution of variation indices such as Extremal Quotient(EQ), Coefficient of Variation(CV), Systematic Component of Variation(SCV) and compare the statistical power among indicies. The simulations was performed on the basis of several assumptions and compared to the empirical data. RESULTS: Main findings can be summarized as follows. 1. If other conditions are constant, the more number of regions, the larger 95 percentile of EQ. But under same situation, 95 percentile of CV and SCV were slightly decreased. 2. If the size of regional population or utilization rate were increased, 95 percentile of all statistics were decreased. Also in the cases of small population size and low utilization rate, 95 percentiles of EQ showed various change contrast to the little change of CV. 3. If the difference at the size of regional population were increased, 95 percentiles of EQ and SCV were increased contrast to the little difference of CV 4. If the utilization rate were increased, 95 percentiles of all indicies were increased. But under the same difference of utilization rate, the power of CV and SCV were increased comparing to no change of the power of EQ. 5. Usually the power of EQ were lower than that of CV or SCV and it is similar between CV and SCV. CONCLUSIONS: Therefore, we suggest that in selecting the variation indicies at the SAV, CV or SCV are superior than EQ in terms of significance level and power.