Direct and Regioselective Palladium(II)-Catalyzed B(4)-H Monoacyloxylation and B(4,5)-H Diacetoxylation of o-Carborane Acids with Phenyliodonium Dicarboxylates.

A direct B(4)-H monoacyloxylation via a Pd-catalyzed regioselective B(4)-H activation of o-carborane acids with phenyliodonium dicarboxylates was developed, and a series of B(4)-H monoacyloxylated o-carboranes decorated with active groups were synthesized with moderate to good yields as well as excellent selectivity. In addition, a direct B(4,5)-H diacetoxylation from o-carborane acids with phenyliodonium diacetate was demonstrated.

The socioeconomic burden of coronary heart disease in Korea.

OBJECTIVES: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. METHODS: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. RESULTS: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). CONCLUSIONS: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

The influence of housing tenure and marital status on smoking in South Korea.

OBJECTIVE: This study aimed to identify the most influential socioeconomic indicator of smoking in South Korea. METHODS: This study analyzed a nationally representative sample (6141 men and 7133 women aged 20-65) from the 2001 and 2005 Korea National Health and Nutrition Surveys. Weighted estimates were computed, adjusting for a complex survey design using "surveyfreq" and "surveylogistic" procedures of SAS 9.1 software. RESULTS: The adjusted OR for smoking in renters compared to homeowners was 1.50 (95% CI: 1.32-1.71) in men and 3.21 (95% CI: 2.41-4.27) in women, and larger in the older than younger groups. For non-married versus married individuals, the OR was 1.37 (95% CI: 1.19-1.59) in men and 3.25 (95% CI: 2.48-4.25) in women; the OR in non-married renters compared married homeowners was 1.79 (95% CI: 1.45-2.22) in men and 10.63 (95% CI: 7.31-15.45) in women. CONCLUSION: Housing tenure was a strong predictor of smoking in South Korea and its significance was very pronounced in non-married individuals. Housing policies to encourage homeownership could be effective in reducing smoking in countries such as China, India, and Vietnam where house ownership is regarded as the ultimate financial safeguard, there are numerous, and traditional attitudes toward marriage are undergoing transition.

Factors influencing cigarette smoking and quantified implications for anti-smoking policy: evidence from South Korea.

OBJECTIVES: The aim of this study was to determine the factors that are associated with adult males' smoking in South Korea and simulate the effects of a potential anti-smoking policy. METHODS: We conducted a national, cross-sectional, telephone survey among males aged 20 years and older in 2006 and analyzed a dataset of 2,847 subjects by using the full information maximum likelihood sample selection model. RESULTS: The likelihood of smoking was highest among the wealthy, employed, Christian, or people who exercise regularly. The low rate of smoking participation was associated with either low pure alcohol intake or increased awareness of lung cancer from smoking. We found that policies to reduce cigarette consumption should focus on lowering smoking participation rather than the amount of cigarettes smoked. Compared to the current state, a policy package consisting of mutually reinforcing measures could reduce the probability of smoking and the average number of cigarettes consumed among all adult males by 34 and 51%, respectively. CONCLUSIONS: Understanding the country-specific factors affecting smoking behavior and selecting an appropriate anti-smoking measure could greatly reduce smoking participation and cigarette consumption.

[Socioeconomic costs of stroke in Korea: estimated from the Korea national health insurance claims database].

OBJECTIVES: To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. METHODS: We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients' and caregivers' productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. RESULTS: A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. CONCLUSIONS: Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

Breast-feeding in South Korea: factors influencing its initiation and duration.

OBJECTIVE: To investigate factors influencing the practices of partial breast-feeding (PBF) and exclusive breast-feeding (EBF). DESIGN: A national, cross-sectional survey was conducted among married women aged 15-49 years from May to August 2003. SETTING: South Korea. SUBJECTS: A total of 865 mothers answered questions regarding the feeding practices of their youngest baby, born between January 2001 and May 2003. RESULTS: The initiation rates of PBF and EBF were 81% and 63%, respectively. However, the median durations of PBF and EBF were very short: 12 and 8 weeks, respectively. According to stepwise logistic and Cox regression analyses, the more prenatal care women received, the more likely they were to initiate PBF and EBF but the less likely to continue EBF. Delivery by Caesarean section decreased the initiation of PBF and EBF. The mother's education level and employment status before marriage, the amount of prenatal care, delivery method and baby's status at birth affected breast-feeding initiation, whereas the amount of prenatal care influenced breast-feeding duration. CONCLUSION: To promote breast-feeding, education and campaigning on the importance of continued breast-feeding should be provided to the general public, particularly to health workers in maternity units.

Changes in mortality after the recent economic crisis in South Korea.

PURPOSE: To examine the changes in all cause mortality and cause-specific mortality after the economic crisis in South Korea. METHODS: Monthly mortality data for an entire country was used and intervention analysis applied to compare mortality after the crisis with mortality which would have occurred if the trends before the crisis had continued. RESULTS: All cause mortality began to increase about 1 year after the crisis, while cardiovascular increased immediately. Transport accidents decreased significantly during the year following the crisis and then regressed towards the pre-economic crisis level. Suicides increased rapidly and maintained an upward trend but subsequently reduced towards the pre-economic crisis level. CONCLUSIONS: This study has shown an evidence of a relationship between economic crisis and mortality.

Impacts of implementing case payment system to medical aid hemodialysis patients on dialysis frequencies and expenditure.

OBJECTIVES: To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. METHODS: Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2, 167 MA and 2, 928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. RESULTS: There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p< 0.05), whereas a significant increase was observed for the MI patients, 2.5% (p< 0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ( (=-70725, p< 0.05). CONCLUSIONS: The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

Changes in morbidity and medical care utilization after the recent economic crisis in the Republic of Korea.

OBJECTIVE: To examine and quantify the impact of the recent economic crisis on morbidity and medical care utilization in the Republic of Korea. METHODS: 22 675 people from 6791 households and 43 682 people from 12 283 households were questioned for two nationwide surveys that took place in 1995 and 1998, respectively. A separate sample pretest-posttest design was used and we conducted c2 test and logistic regression analysis after controlling for the maturation effect of the morbidity and medical care utilization. FINDINGS: The morbidity rates of chronic disease and acute disease increased significantly by 27.1% and 9.5%, respectively, whereas the utilization rates of outpatient and inpatient services decreased by 15.1% and 5.2%, respectively. In particular, the pace of decline in the utilization rate of outpatient services varied depending on the type of disease: morbidity rates for mental and behavioural disorders were 13.7%; for cardiovascular disease, 7.1%; and for injury, 31.6%. CONCLUSION: After the Republic of Korean economic crisis, the morbidity and medical care utilization rates changed significantly but the degree of change depended on the type of disease or service. The time-dependent relationship between the national economy and the morbidity and medical care utilization rates needs to be further investigated.