Prevalence of atopic dermatitis in Korea: analysis by using national statistics

We attempted to investigate the prevalence of atopic dermatitis (AD) in Korea by using national statistics. Data on AD patients who received medical service at least once a year from 2003 through 2008 were collected from health insurance research team of National Health Insurance Corporation. Data of estimated populations during the same period were obtained from the Statistics Korea. In 2008, the prevalence of AD was 26.5% in aged 12-23 months and decreased substantially to 7.6% at age 6 yr, 3.4% at age 12 yr and to 2.4% at age 18 yr. In males, the prevalence was higher than females until 2 yr of age, while the opposite was shown in children aged 2 yr or older. In children aged less than 24 months, the prevalence of AD has increased from 19.8% to 23.8% between the years 2003 and 2008, while the prevalence showed no increase in the older age group. In conclusion, the prevalence of AD in 2008 peaked during infancy up to 26.5% and decreased thereafter. Our findings also suggest that increasing prevalence of AD in children less than 24 months might be responsible for the recent increase in the prevalence of AD in Korean children.     

院前急救模式对道路交通伤救治结局的影响

目的探索院前"医警联动"急救新模式和旧模式对道路交通事故伤病人救治结局的影响。方法通过对比分析新旧模式的道路交通事故伤共3 673例病人的救治数量、病人严重程度分布、不同严重程度病人救治结局,了解新道路交通事故伤急救模式对交通伤病人救治结局的影响。结果与旧模式比较,新模式对道路交通事故伤病人院前急救的时间(P0.05)和距离明显缩短(P0.01),收治的危急重道路交通事故伤病人比例从0.06%升高至3.66%,危急重病人死亡率降低至12.16%,但是轻中度伤病人死亡率增至4.54%。结论院前"医警联动"急救新模式明显缩短了道路交通事故伤病人急救时间和距离,提高了重度伤病人救治成功率,提高道路交通事故伤危急重伤病人的救治效率。     

Study of head injury victims in fatal road traffic accidents in Delhi

The study revealed 31% were the victims of Head injury injury in this part of Delhi in vehicular accidents. Although majority of the fatalities were on the spot quite a number of such victims survived for a varied period. A multipronged approach including the preventive and curative measures for this man-made calamity is the need of the hour. Amongst various preventive measure are wearing helmet be made compulsory for both the driver and pillion riders of two-wheelers, development of a safe traffic sense amongst the road users. Traffic Police should be honest, exemplary punishment for the reckless driver, decongestion of Delhi roads etc. The curative measures are facilities of CT scanners and neurosurgeons in all the major hospitals, provision of first-aid in the PCR (Police control room) vans, to institute immediate treatment to the victim without waiting for the medico-legal formalities, opening of more fully equipped Accident and trauma centres. It is high time the concerned authorities gave some serious thought towards this avoidable epidemic on Delhi roads.     

Intraindividual variability as an indicator of malingering in head injury.

The utility of various measures of malingering was evaluated using an analog design in which half the participants (composed of three groups: naive healthy people, professionals working with head-injured people, individuals who suffered a head injury but not currently in litigation) were asked to try their best and the remainder was asked to feign believable injury. Participants were assessed with the Reliable Digit Span (RDS) task, the Victoria Symptom Validity Test (VSVT), and the Computerized Dot Counting Test (CDCT) on three separate occasions in order to determine whether repeat administration of tests improves prediction. The results indicated that regardless of an individual's experience, consideration of both level of performance (particularly on forced-choice symptom validity tasks) and intraindividual variability holds considerable promise for the detection of malingering.     

Nationwide incidence estimation of lung cancer in Korea.

The aim of this paper is to estimate the nationwide incidence rate of lung cancer in Korea. The potential incident cases were identified by hospital visiting and mailing, based on the ICD-9 diagnostic codes on the claims as one of the following: ICD-9 162-165 (malignant neoplasms of the respiratory system), 212 (benign neoplasm), 231 (carcinoma in situ), 511 (pleurisy), or 195-199 (malignant neoplasms with uncoded sites) in beneficiaries data of the Korea Medical Insurance Corporation from January, 1988 to December, 1989. Thereafter, the identified cases were confirmed by an oncologist (Dr. DS Heo). When adjusted with age distribution of the Korean population based on the 1985 Population Census, the incidence rate was 22.3 per 100,000 in males (95% CI: 21.70-23.01) and 8.37 (95% CI: 7.97-8.78) in females in 1989. And the age-adjusted rate for the world population was 39.63 in males and 9.95 in females.     

The effects of age on accident severity and outcome in Irish road traffic accident patients

Road traffic accidents (RTA's) are the leading cause of fatal trauma in Ireland. Although older drivers are the safest group of drivers in the population, once involved in a crash they are more likely to sustain a severe injury or death. The experiences of Irish elderly RTA victims has not been previously documented. We studied older RTA patients admitted to two Irish trauma centres in 1995. Of 525 patients, 39 (7%) were aged over 65. We compared 38 patients aged 16-64 years for comparison and reviewed the notes in detail. Elderly patients were mostly pedestrians (23/38 - 61%) though 21% (8/38) were drivers with 8% (3/38) on public transport. Younger patients were mostly drivers (14/37 - 38%), cyclists (9/37 - 24%) or motorcyclists (7/37 - 19%). Older patients had a higher median Injury Severity Score, p < 0.05, were more likely to be female (p<0.01), involved in RTA's between 9am-5pm (p<0.05) and have pre-existing medical conditions (p<0.01). The following were significantly increased in older patients (p values): surgical (<0.01), medical (<0.01) and therapist workload (p<0.05), complications (<0.0001), length of stay (<0.01). Less elderly were discharged directly to home (p<0.001). Strategies to reduce the mortality and morbidity associated with RTA in the elderly should emphasise a) older pedestrians during daytime hours, b) attention to safety in public transport. Treatment must ensure adequate medical and therapist input to anticipate higher complication rates.     

Identification of malingered head injury on the Halstead-Reitan battery.

Heaton et al. (1978) demonstrated that the performance of malingerers and actual head trauma patients could be distinguished on the HRB by discriminant analysis. The present study replicated Heaton et al.'s methodology on a larger sample to provide a more stable function for discriminating simulated and real head trauma. Malingerers (n = 80) were instructed to fake severe deficits without being obvious. Patients (n = 80) had documented trauma and were not litigating for compensation. Groups were matched on age, gender, and overall Impairment Index to permit comparisons between patterns of performance. A crossvalidated step-wise discriminant function correctly identified 88.75% of the groups, with 83.8% true positives and 93.8% true negatives. This function was applied to several published data sets. Both malingerer and patient groups were accurately identified in Heaton et al. (1978) and Trueblood and Schmidt (1993). Faust et al.'s (1988) adolescent malingerer and the malingered performance of three litigating patients published by Cullum et al. (1991), were also correctly classified.     

Average heterozygosity per locus in man: an estimate based on the incidence of enzyme polymorphisms

1. Data from electrophoretic surveys of enzymes in European populations are reviewed. 2. Out of the seventy-one structural gene loci determining enzyme structure which have been scrutinized electrophoretically, 20 (28 %) were found to show genetic polymorphism. The average heterozygosity per locus for alleles determining electrophoretic variants is estimated at 0·067. 3. These results are compared with data from some other species. 4. For several different reasons, most of which relate to the techniques used and the enzymes and tissues surveyed, it seems likely that the present data considerably underestimate the true incidence of polymorphism and average heterozygosity per locus.     

Driving after severe head injury: the need for assessment.

This paper reports on a survey of return to driving after severe head injury. It highlights the lack of information provision, low rates of Driver and Vehicle Licensing Agency (DVLA) notification, and poor uptake of driving assessments. The findings highlight the need for liaison between head injury services and general practitioners (GPs) when assessing driving fitness.     

Estimation of the burden of major cancers in Korea

We estimated the burden of diseases in Korea especially caused by major cancers using DALY (disability adjusted life year) measurement. Firstly, the burden of disease due to premature death was estimated by using YLLs (years life lost due to premature death) measurement developed by the global burden of disease study group. Secondly, for the calculation of the YLD (years lived with disability), the following parameters were estimated in the formula; incidence rate, case fatality rate and disability weight of major cancers. Thirdly, we estimated DALY of major cancers by adding YLLs and YLDs. The burden of major cancers for male per 100,000 population was attributed mainly to liver cancer (528.8 person-year), stomach cancer (451.4 person-year), and lung cancer (374.9 person-year). The burden of major cancers for female per 100,000 population was attributed mainly to liver cancer (140.0 person-year), stomach cancer (259.7 person-year), and lung cancer (125.2 person-year). Each of these cancers was responsible for the loss of over 100 person-year per 100,000 population based on our DALY measurement. We found the DALY method employed was appropriate to quantify the burden of disease. Thereby, it would provide a rational bases to plan a national health policy regarding the burden of disease caused by major cancers in Korea.     

Cost-effectiveness analysis of telemedical devices for pre-clinical traffic accident emergency rescue in Germany.

OBJECTIVES: The purpose of this study is to assess the cost-effectiveness (net costs per life year gained) of telemedical devices for pre-clinical traffic accident emergency rescue in Germany. METHODS: Two equipment versions of a telemedical device are compared from a societal perspective with the baseline in Germany, i.e. the non-application of telemedicine in emergency rescues. The analysis is based on retrospective statistical data covering a period of 10 years with discounted costs not adjusted for inflation. Due to the uncertainty of data, certain assumptions and estimates were necessary. The outcome is measured in terms of "life years gained" by reducing therapy-free intervals and improvements in first-aid provided by laypersons. RESULTS: The introduction of the basic equipment version, "Automatic Accident Alert", is associated with net costs per life year gained of euro 247,977 (at baseline assumptions). The full equipment version of the telemedical device would lead to estimated net costs of euro 239,524 per life year gained. Multi-way sensitivity-analysis with best and worst case scenarios suggests that decreasing system costs would disproportionately reduce total costs, and that rapid market penetration would largely increase the system's benefit, while simultaneously reducing costs. CONCLUSION: The net costs per life year gained in the application of the two versions of the telemedical device for pre-clinical emergency rescue of traffic accidents are estimated as quite high. However, the implementation of the device as part of a larger European co-ordinated initiative is more realistic.     

1991 cancer incidence in Seoul,Korea: results of the Implementation Study of the Seoul Cancer Registry.

This article presents the results of the Implementation Study of the Seoul Cancer Registry, which started in July, 1991 as a population based cancer registry in Seoul, Korea. The completeness and validity of the registered data were evaluated using Mortality/Incidence ratio (M/I ratio), Histologically Verified Cases (HV%), Primary Site Uncertain (PSU%), and Age Unknown (Age UNK%). Owing to the additional active surveillance, the completeness of the data turned out to be fairly acceptable, except for the aged over 75(Mortality/Incidence ratio was over 100%). Eventhough the Seoul cancer registry(SCR) has further way to go in the completeness especially among elderly persons, the validity of SCR data was also acceptable in terms of HV%, PSU%, and Age UNK%. However, PSU% and Age UNK% might need to be further reduced to be comparable with other well established cancer registries. The age standardized incidence rates(ASR) of all cancers between July 1, 1991 and June 30, 1992 were 232.4/100,000 in males and 147.9/100,000 in females. The top five major sites of cancers in Seoul were the stomach, liver, lung, colo-rectum, and bladder in order in males, and the uterine cervix, stomach, breast, colo-rectum, and liver in females. Those 5 cancer sites comprised 68.9% and 64.7% of the total cancer incidence in males and females, respectively.     

Cognitive remediation in pediatric head injury: a case study.

Little work has been done in delineating cognitive remediation approaches for pediatric survivors of head injury. The use of a cognitive remediation approach is described in a case study of a 16-year-old male, who was 1 1/2 years post severe traumatic brain injury. Specific techniques and treatment course are outlined to demonstrate the model offered as one meeting the unique needs of the pediatric survivor. This model emphasizes a behavioral, individually tailored approach with clear delineation of a functional academic skill goal of competence in mathematical computation. Results indicate accomplishment of goals and some generalization of skills obtained to a math domain that was not the major focus of the remediation attempts.     

Detection of feigned head injury symptoms on the MMPI-2 in head injured patients and community controls.

MMPI-2 results from 39 moderately to severely head injured (HI) and 44 community volunteer (CV) participants given instructions to feign symptoms or answer honestly during an analog forensic neuropsychological examination were compared. No significant effects for HI or the interaction between the HI and instruction set (IS) factors were noted on either clinical or selected validity scales (F, Fb, Fp, Ds2, FBS). However, the main effect of IS was significant for both clinical and validity scales (median Cohen's d=1.34 and 1.39, respectively). Most validity scales were characterized by perfect specificity rates but low to modest sensitivity, whereas FBS had both moderate sensitivity and specificity. Logistic regressions showed that the F and Ds2 scales made a significant contribution independent of motivational tests to the identification of feigning during neuropsychological examination.     

Estimation of cancer deaths in Korea for the upcoming years

Since the cancer has been the leading cause of deaths in Korea, estimation of the cancer deaths for the upcoming years in the population using the vital statistics is considered to be necessary. The aim of this study was to estimate the number and trends of cancer deaths in Korea. The expected numbers of cancer deaths were calculated by a time series model fitting the actual numbers of cancer deaths for each of the years 1983 through 2000 reported by Korea National Statistical Office. The options selected for the time series model included a quadratic time trend, which incorporated long-term information into the model and an autoregressive component which incorporated information about short-term fluctuations. The forecasting numbers of cancer deaths and their 95% confidence intervals were estimated for both genders and primary sites. The forecasting number of deaths from all cancers is increasing so that the cumulative number of expected cancer deaths between 2001 and 2005 would be about 309 thousand persons. Cancers of the lung, stomach, liver, and colorectum continue to be the most common causes of cancer deaths. While the numbers of expected cancer deaths in the stomach and liver show a decreasing trend, the cancer in the lung, colorectum, pancreas, breast, and oral cavity have an increasing trend. These observations indicate that cancer deaths in the near future would be increasing through the early 2000s, and there should be some urgent government's policy on the cancer management.     

Pseudoaneurysm of the occipital artery: an unusual cause of persisting headache after minor head injury

Post-traumatic pseudoaneurysms of the extracranial arteries in the scalp are uncommon sequelae of head injury. We report on a patient who presented four weeks after a minor head injury with a tender, pulsating and enlarging mass in the course of the left occipital artery. There was associated headache radiating to the vertex. Computed tomographic angiography confirmed the lesion to be a pseudoaneurysm of the occipital artery. The lump was resected with complete resolution of symptoms.     

All-time high tularaemia incidence in Norway in 2011: report from the national surveillance

Tularaemia has mainly been a sporadic disease in Norway. In 2011, 180 persons (3.7 per 100,000 population) were diagnosed with tularaemia. This article describes the epidemiological and clinical features of tularaemia cases during a year with exceptionally high tularaemia incidence. Data from the national reference laboratory for tularaemia combined with epidemiological data from the Norwegian Surveillance System for Communicable Diseases (MSIS) were used. The incidence of tularaemia varied greatly between counties, but almost every county was involved. The majority (77.8 %) of the cases were diagnosed during the autumn and winter months. The geographic distribution also showed seasonal patterns. Overall, oropharyngeal tularaemia (41.1 %) was the most common clinical presentation, followed by glandular (14.4 %), typhoidal (14.4 %), respiratory (13.3 %) and ulceroglandular (12.8 %) tularaemia. From January to April, oropharyngeal tularaemia dominated, from May to September, ulceroglandular tularaemia was most common, whereas from October to December, there was an almost even distribution between several clinical forms of tularaemia. Eighty-five (47.2 %) of all tularaemia cases were admitted to, or seen as outpatients in, hospitals. An unexpectedly high number (3.9 %) of the patients had positive blood culture with Francisella tularensis. The clinical manifestations of tularaemia in Norway in 2011 were diverse, and changing throughout the year. Classification was sometimes difficult due to uncharacteristic symptoms and unknown mode of transmission. In rodent years, tularaemia is an important differential diagnosis to keep in mind at all times of the year for a variety of clinical symptoms.     

Meningococcal disease in the republic of Korea army: incidence and serogroups determined by PCR

This study was performed to determine the incidence and serogroups of meningococcal disease in the Korean Army. From August 2000 to July 2001, we identified prospective cases in the Korean Army. Meningococcal disease was confirmed by isolation of Neisseria meningitidis or detection of its antigen by latex agglutination from cerebrospinal fluid (CSF) or blood. Polymerase chain reactions (PCRs) were performed in the crgA gene to identify N. meningitidis regardless of its serogroup, and then in orf-2 (serogroup A) and siaD (serogroups B, C, Y, and W135) respectively for serogroup prediction. During the study period, twelve patients (four meningitis and eight septicaemia) were identified. The annual incidence was 2.2 per 100,000 (95% confidence interval, 1.3-3.8) among 550,000 private soldiers. Latex agglutinations were positive to A/C/Y/W135 polyvalent latex, but not to B latex in all patients. PCRs of crgA gene were positive in ten patients, whose samples (2 isolates from CSF, 2 CSFs, and 6 sera) were stored. In PCRs for serogroup prediction, one isolate was serogroup A, and one isolate and two sera were serogroup C. The need for meningococcal vaccination would be considered in the Korean Army through the cost-benefit analysis based on the result of this study.