Decreasing Trends of Neonatal and Infant Mortality Rates in Korea: Compared with Japan, USA, and OECD Nations

Neonatal mortality rate (NMR) and infant mortality rate (IMR) are two of the most important indices reflecting the level of public health of a country. In this review, we investigated changes in NMR and IMR in Korea and compared the results with those of Japan, USA, and OECD nations. During the past 20 yr, NMR and IMR have lowered remarkably from 6.6 and 9.9 in 1993 to 1.7 and 3.2 in 2009, respectively, in Korea. It is an impressive finding that Korean IMR (3.2 in 2009) is lower than the average of OECD nations (4.7 in 2008), and USA (6.3 in 2009), although higher than Japanese IMR (2.8 in 2009). The proportion of NMR among the IMR calculation decreased from 66.7% in 1993 to 53.1% in 2009. The reason the value of Korea was higher than Japan but lower than USA was speculated to be an aspect of the health care service system. Several suggestions in perinatal, neonatal and infantile health care such as establishment of perinatal care center, research network system, regionalization, and new policies for care of pre-term and high risk pregnancy, are elucidated to achieve further improvement on NMR and IMR in Korea

Experimental Verification of Overlimiting Current by Surface Conduction and Electro-Osmotic Flow in Microchannels

Direct evidence is provided for the transition from surface conduction (SC) to electro-osmotic flow (EOF) above a critical channel depth (d) of a nanofluidic device. The dependence of the overlimiting conductance (OLC) on d is consistent with theoretical predictions, scaling as d[superscript −1] for SC and d[superscript 4 over 5] for EOF with a minimum around d=8  μm. The propagation of transient deionization shocks is also visualized, revealing complex patterns of EOF vortices and unstable convection with increasing d. This unified picture of surface-driven OLC can guide further advances in electrokinetic theory, as well as engineering applications of ion concentration polarization in microfluidics and porous media.Basic Science Research Program (Grant 2013R1A1A1008125)Global Frontier Project (Center for Integrated Smart Sensor. Grant CISS-2011-0031870)Future Based Technology Development Program (Nano Fields) (Grant 2012-0001033)Korea. Ministry of Health and Welfare (Grant HI13C1468)Korea. Ministry of Health and Welfare (Grant HI14C0559)Korea (South). Ministry of Science, ICT and Future Planning (Korean Health Technology RND Project

Changes in the neonatal and infant mortality rate and the causes of death in Korea

Neonatal mortality rate (NMR) or infant mortality rate (IMR) are the rate of deaths per 1,000 live births at which babies of either less than four weeks or of one year of age die, respectively. The NMR and IMR are commonly accepted as a measure of the general health and wellbeing of a population. Korea's NMR and IMR fell significantly between 1993 and 2009 from 6.6 and 9.9 to 1.7 and 3.2, respectively. Common causes of infantile death in 2008 had decreased compared with those in 1996 such as other disorders originating in the perinatal period, congenital malformation of the heart, bacterial sepsis of newborns, disorders related to length of gestation and fetal growth, intra-uterine hypoxia, birth asphyxia. However, some other causes are on the increase, such as respiratory distress of newborn, other respiratory conditions originating in the perinatal period, other congenital malformation, diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. In this study, we provide basic data about changes of NMR and IMR and the causes of neonatal and infantile death from 1983 to 2009 in Korea

Comparison of major dish item and food group consumption between normal and obese Korean children: application to development of a brief food frequency questionnaire for obesity-related eating behaviors

This study sought to compare intake levels of major dish items and food groups between normal and obese Korean children in order to understand obesity-related eating behaviors. The study was also conducted to apply the information on the differences in major dish items and food groups found in this study to development of a brief food frequency questionnaire (FFQ) for children's obesity-related eating behaviors. Finally, the developed FFQ was evaluated for reliability. A total of 290, 24-hour dietary recall data from 9-11 year-old normal or obese participants in the 2001 Korean National Health and Nutrition Examination Survey (KNHANES) were reviewed to identify dish items and food groups showing outstanding differences between the normal and obese groups. Based on the level of intake amount between the two groups, a total of 7 items, including ddeokbokggi, spaghetti, ham roast, pork cutlet, dairy products & ices, kimchi, and fruits, were selected to be included in the FFQ. The former 5 items were seen to be consumed more in the obese group, while the latter 2 items were so in the normal group. The questionnaire was formatted into a frequency response section of a seven-category option and reference period of the last 7 days. Test-retest reliability of the developed FFQ was examined by administering it to 153, 9-11 year-old children at a public elementary school in Seoul twice at a month interval. The level of reliability was found to be reasonably high. In conclusion, this study suggests that high consumption of several high-calorie dish items and low consumption of kimchi and fruits may be important eating behaviors in relation to obesity risk among 9-11 year-old children who need nutrition educators' attention. The current study also implies that a simple FFQ can be utilized to reliably assess 9-11 year-old children's diets

Negative Self-Regulation of TLR9 Signaling by Its N-Terminal Proteolytic Cleavage Product

TLR signaling is essential to innate immunity against microbial invaders and must be tightly controlled. We have previously shown that TLR9 undergoes proteolytic cleavage processing by lysosomal proteases to generate two distinct fragments. The C-terminal cleavage product plays a critical role in activating TLR9 signaling; however, the precise role of the N-terminal fragment, which remains in lysosomes, in the TLR9 response is still unclear. In this article, we report that the N-terminal cleavage product negatively regulates TLR9 signaling. Notably, the N-terminal fragment promotes the aspartic protease-mediated degradation of the C-terminal fragment in endolysosomes. Furthermore, the N-terminal TLR9 fragment physically interacts with the C-terminal product, thereby inhibiting the formation of homodimers of the C-terminal fragment; this suggests that the monomeric C-terminal product is more susceptible to attack by aspartic proteases. Together, these results suggest that the N-terminal TLR9 proteolytic cleavage product is a negative self-regulator that prevents excessive TLR9 signaling activity.Korea (South). Ministry of Education, Science and Technology (MEST) (National Research Foundation of Korea. Grant 2011-0015372)Korea (South). Ministry of Education, Science and Technology (MEST) (National Research Foundation of Korea. Grant 2010-0009203)Korea. Ministry of Health and Welfare. National Research and Development Program for Cancer Contro

Human Behavior Impacts on Health Care

It is critical to understand human behavior in order to implement effective health-care policies for both developing and industrialized countries. Human behavior issues were studied in Ghana, with a developing economy, and South Korea, with a developed economy. From the survey research in Ghana in 2014, we learned that rural residents are heavily dependent on traditional health care. However, local community residents preferred to talk to medical doctors about their health care when accessible. We also looked into human behavior issues and the unique hospital culture in South Korea that contributed to the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in 2015, incorporating human behavior into the SIR (susceptible-infected-recovered) model of infectious disease transmission. Moreover, we closely examined the impacts of human behavior and offered suggestions for the integration of human behavior in health-care policy

Estimating the lifetime economic burden of stroke according to the age of onset in South Korea: a cost of illness study

<p>Abstract</p> <p>Background</p> <p>The recently-observed trend towards younger stroke patients in Korea raises economic concerns, including erosion of the workforce. We compared per-person lifetime costs of stroke according to the age of stroke onset from the Korean societal perspective.</p> <p>Methods</p> <p>A state-transition Markov model consisted of three health states ('post primary stroke event', 'alive post stroke', and 'dead') was developed to simulate the natural history of stroke. The transition probabilities for fatal and non-fatal recurrent stroke by age and gender and for non-stroke causes of death were derived from the national epidemiologic data of the Korean Health Insurance Review and Assessment Services and data from the Danish Monitoring Trends in Cardiovascular Disease study. We used an incidence-based approach to estimate the long-term costs of stroke. The model captured stroke-related costs including costs within the health sector, patients' out-of-pocket costs outside the health sector, and costs resulting from loss of productivity due to morbidity and premature death using a human capital approach. Average insurance-covered costs occurring within the health sector were estimated from the National Health Insurance claims database. Other costs were estimated based on the national epidemiologic data and literature. All costs are presented in 2008 Korean currency values (Korean won = KRW).</p> <p>Results</p> <p>The lifetime costs of stroke were estimated to be: 200.7, 81.9, and 16.4 million Korean won (1,200 KRW is approximately equal to one US dollar) for men who suffered a first stroke at age 45, 55 and 65 years, respectively, and 75.7, 39.2, and 19.3 million KRW for women at the same age. While stroke occurring among Koreans aged 45 to 64 years accounted for only 30% of the total disease incidence, this age group incurred 75% of the total national lifetime costs of stroke.</p> <p>Conclusions</p> <p>A higher lifetime burden and increasing incidence of stroke among younger Koreans highlight the need for more effective strategies for the prevention and management of stroke especially for people between 40 and 60 years of ages.</p