Is It Safe to Eat Fish?

No abstract available.

The Prevalence of Chronic Diseases among Migrants in Korea According to Their Length of Stay and Residential Status / 가정의학회지

BACKGROUND: Migrant health is becoming public health issues, as the migrant populations are increasing and their length of stay is prolonged. This study aims to analyze the differences in prevalence of chronic diseases among migrants according to length of stay and residential status. METHODS: An initial population pool were 3,024 who were assessed with health screening programs by Migrant Health Association. 2,459 migrants were selected for final analysis. Via Stata 10 we conducted univariate logistic regression analysis to examine the effects of their length of stay and residential status on the prevalence of hypertension, diabetes, dyslipidemia, and obesity. In the final analysis, the result of each sex was adjusted for age, nationality, length of stay, and residential status via multiple logistic regression analysis. RESULTS: Longer length of stay tends to increase the prevalence of hypertension in male; 4-6 year stay-duration group demonstrated statistically significant excess compared to 1 year or less stay-duration group (adjusted odds ratio [OR], 1.39; confidence interval [CI], 1.01 to 1.92). After adjustment, male migrants stayed more than 7 year showed considerably higher dyslipidemia than male migrants stayed less than 1 year (adjusted OR, 1.95; CI, 1.05 to 3.64). Compared to the group with 1 year or less stay-duration, the prevalence of obesity in male was significantly higher among 4-6 year (adjusted OR, 1.65; CI, 1.17 to 2.32) and 7 year or more stay-duration group (adjusted OR, 1.65; CI, 1.11 to 2.45). CONCLUSION: Longer length of stay correlated to higher prevalence of hypertension, dyslipidemia, and obesity among some population of migrants. So more researches and new developing policies are needed for this problem.

Patient Assessment of Primary Care of Health Cooperative Clinics in South Korea / 가정의학회지

BACKGROUND: In South Korea, major health care problems have been occurred under the structural background that medical services are mainly provided by private medical institutions. Primary health care, which is very crucial in public health, has been overlooked, and is disorganized and fragmented. In the mean time, health cooperative movement was initiated by local residents and medical doctors to overcome health care problems in 1987. We conducted this study to evaluate the role of health cooperative clinics and obtain lessons for the future primary care policy. METHODS: During April to June in 2007, survey was performed by a trained interviewer at the waiting rooms of 3 health cooperative clinics, in the process of development of the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of 5 domains (21 items): first contact (5), coordination function (3), comprehensiveness (4), family/community orientation (4), and personalized care (5). Subjects were patients (or guardians) who had visited their health cooperative clinics on six or more occasions over a period of more than 6 months. We compared primary care scores of each domain between members and non-members of health cooperative clinics by student t-test. Effect of having a membership on each primary care domains was examined by multiple regression analysis. RESULTS: Among the participants (N = 100), members of health cooperatives were 48, and non-members 52. Total average scores of 5 primary care domains of the KPCAT were 78.0 +/- 13.5 on 100 point scale. (82.0 +/- 13.1 in members, and 74.3 +/- 13.0 in nonmembers; P = 0.004) Among primary care domains, personalized care was the highest (91.4 +/- 11.0), and coordination function the lowest (61.0 +/- 33.1) in score. Significant differences between members and nonmembers were noted in coordination function (68.9 vs. 53.7, P = 0.021) and comprehensiveness (78.4 vs. 67.2, P = 0.008). These differences were continued after adjusting by multiple regression analysis for socio-demographic variables including age, sex, income, education, number of disease, and duration since the first visit. CONCLUSION: In the health cooperative clinics whose primary care performance has been considered exemplary in the context of health care in South Korea, primary care scores assessed by members were higher than those by non-members. The significant differences of scores in coordination function and comprehensiveness between members and nonmembers suggest that the future primary care policy should be focused to strengthen these two domains of primary care.

Korean Academy of Medical Sciences Pediatric Impairment Guideline for Brain Lesion

The permanent impairment evaluation for children in developmental stage is very difficult and it is even impossible in some cases. The impairment evaluation for developing children has not yet been included in the guideline of the American Medical Association. Due to frequent medical and social demands in Korea, we developed an impairment evaluation guideline for motor impairment, intellectual disability/mental retardation, developmental speech-language disorder and epilepsy caused by pediatric cerebral injuries, or cerebral lesions other than the developmental disorders such as autism. With the help of various literature and foreign institutions, we developed our in order to develop a scientific guideline for pediatric impairment that is suited to Korean cultural background and social condition.

Megatrends and Perspectives of Emerging Medical Services

In the era of u-health, the megatrends of new medical services are the use of information and communication technologies to provide health care information and services to stakeholders including medisumers. They pursue improved quality of health care, increased access to information and process, cost-saving, industry development related to u-Health, and enforcement of competitiveness. The goals of activating u-Health are to improve laws and regulations, to provide incentives, to increase government support and establish a monitoring system, and to encourage financial investment for institutes related to health service market for an effective health system. Characteristics of megatrends in the era of u-health are represented as 5 c's: content, community, commerce, connectivity, and care. It contains the development of 'contents' for u-health, share and exchange information in the 'u-community', promote 'commercial u-health care models', 'connectivity' for standardization, activating 'care for network governance' by developing services, and build a value- and IT-based and patient-centered purchasing system, which will bring a paradigm shift in medical services.

A Case of Recurrent Pneumatosis Cystoides Intestinalis Associated with Recurrent Pneumoperitoneum / 대한소화기학회지

Pneumatosis cystoides intestinalis is an uncommon condition of unknown etiology, characterized by the presence of multiple gas filled cysts in the gastrointestinal tract. Many different causes of pneumatosis cystoides intestinalis have been proposed, including mechanical, pulmonary, and bacterial causes. Approximately 85% of cases are thought to be secondary to coexisting disorders of the gastrointestinal tract or the respiratory system. The condition has been associated with the therapeutic uses of lactulose, steroids, and various cancer chemotherapeutic regimens. Lactitol is a disaccharide analogue of lactulose which is available as a pure crystalline powder. There are three previous case reports suggestive of lactulose causing pnumatosis intestinalis. We report a case of recurrent pneumatosis cystoides intestinalis associated with benign recurrent pneumoperitoneum developed probably secondary to lactitol therapy.

Development of an Evaluation Checklist for Internet Health/Disease Information / 대한의료정보학회지

OBJECTIVE: This study was conducted to develop Internet health information evaluation checklist for medical professionals, web coordinators or managers, and general health information consumers. METHODS: Based on the literature review, evaluation model and prototype of evaluation checklist for Internet health information were developed. Expert group of Internet quality evaluation reviewed and refined original evaluation checklist through intensive focus group meetings. Revised web-based evaluation checklist for Internet health information was verified by medical professionals, web health information managers, and online members of National Health Insurance Corporation. RESULTS: The checklist for medical professionals consisted of 28 items to check 3 categories such as disease information, operation/procedure/examination information, and health/life pattern information. The checklist for health information managers focused on primary filtering of health information and consisted of 14 items. This can be utilized for automatic selection of health information in portal systems. The checklist for consumers consisted of 10 items and focused on convenience and utility of the evaluation tool for enhancing the acceptability. CONCLUSION: Continuous development and revision of health information evaluation checklist like this study can be useful way for improving Internet health information quality.

Presentation of Structural Constraints for Discharge Note According to Clinical Document Architecture Standard / 대한의료정보학회지

OBJECTIVE: HL7(Health Level 7) develops standards for the representation of clinical documents like discharge and consultation notes. The goal of the present study is to develop XML(eXtensible Markup Language)-based communication standard for discharge note. METHODS: This paper presents the use of XML for electronic communication in a document-based EMR, first, as a format for the exchange of structured message, and second, as a comprehensible way to represent patient document. A retrospective analysis of 1165 discharge notes, from the department Seoul National University Hospital, were extracted by querying OCS(Order Communication System) and taking every discharge note of main disease issued over one year period (2003.01.01~2003.12.31). RESULTS: An XML-based prototype for discharge note has been put into place representing the required "section" and "specific instance". In addition, a subset of the CDA(Clinical Document Architecture) Level One details has been described and integrated. CONCLUSION: Through the introduction of definitions for sections and specific instances, progress in the development of CDA Level Two and Three might be realized. An XML-based prototype was implemented, allowing a special view on XML data to generate this document type.

A Study of Effective Unified Medical Language System Concept Indexing in Radiology Reports / 대한의료정보학회지

OBJECTIVE: For the effective retrieval of clinical information, the elaborate indexing is essential. Two major types of indexing are the human indexing and the automatic or machine indexing. Human indexing shows higher quality but is time consuming, labor-intensive and inconsistent in term assignment activity. METHODS: Using the Unified Medical Language System (UMLS) MetaMap program, we mapped the free text from the diagnosis section of radiology reports into UMLS concepts. To improve the precision of UMLS concept indexing by MetaMap, we evaluated the UMLS subset mapping and semantic type filtering methods, determining the best combination for improved precision. RESULTS: After calculating the candidates from subset combinations, we obtained more enhanced results by semantic-type filtering. CONCLUSION: The results may be improved for the complete automation of indexing process.