Journal of Preventive Medicine and Public Health

Sue Kyung Park

20 Articles

Association of Selected Medical Conditions With Breast Cancer Risk in Korea: Sun Jae Jung, Minkyo Song, Ji-Yeob Choi, Nan Song, Sue Kyung Park, Keun-Young Yoo, Daehee Kang; J Prev Med Public Health. 2013;46(6):346-352. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.346

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Objectives

To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study.

Methods

The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer.

Results

Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer.

Conclusions

Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.

Summary

Citations

Citations to this article as recorded by

Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta‐analysis
Fanxiu Xiong, Qichen Dai, Sihan Zhang, Stephen Bent, Peggy Tahir, Erin L. Van Blarigan, Stacey A. Kenfield, June M. Chan, Gabriela Schmajuk, Rebecca E. Graff
Diabetes/Metabolism Research and Reviews.2024;[Epub] CrossRef
Reverse Onco-Cardiology: What Is the Evidence for Breast Cancer? A Systematic Review of the Literature
Ioannis Boutas, Adamantia Kontogeorgi, Sophia N. Kalantaridou, Constantine Dimitrakakis, Panagiotis Patsios, Maria Kalantzi, Theodoros Xanthos
International Journal of Molecular Sciences.2023; 24(22): 16500. CrossRef
Association of Hypertension and Organ-Specific Cancer: A Meta-Analysis
Morgan Connaughton, Mahsa Dabagh
Healthcare.2022; 10(6): 1074. CrossRef
Association between blood pressure and risk of cancer development: a systematic review and meta-analysis of observational studies
Aristeidis Seretis, Sofia Cividini, Georgios Markozannes, Xanthippi Tseretopoulou, David S. Lopez, Evangelia E. Ntzani, Konstantinos K. Tsilidis
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Risk of breast cancer among women with benign ovarian tumors: a Danish nationwide cohort study
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Breast Cancer Research and Treatment.2019; 178(1): 199. CrossRef
Detection of human papillomavirus DNA in tumors from Rwandese breast cancer patients
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Hypertension and breast cancer risk: a systematic review and meta-analysis
Hedong Han, Wei Guo, Wentao Shi, Yamei Yu, Yunshuo Zhang, Xiaofei Ye, Jia He
Scientific Reports.2017;[Epub] CrossRef
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L. Bernard, N. Reix, J.-C. Benabu, V. Gabriele, C. Mathelin
Gynécologie Obstétrique & Fertilité.2016; 44(12): 701. CrossRef
Associations between Medical Conditions and Breast Cancer Risk in Asians: A Nationwide Population-Based Study in Taiwan
Shu-Chun Chuang, Guo-Jie Wu, Yen-Shen Lu, Ching-Hung Lin, Chao Agnes Hsiung, Pei-Yi Chu
PLOS ONE.2015; 10(11): e0143410. CrossRef
Detection of MMTV-Like sequences in Moroccan breast cancer cases
Meriem Slaoui, Mohammed El Mzibri, Rachid Razine, Zineb Qmichou, Mohammed Attaleb, Mariam Amrani
Infectious Agents and Cancer.2014;[Epub] CrossRef
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Shinan Yin, Hua Bai, Danqing Jing
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A Prospective Cohort Study on the Relationship of Sleep Duration With All-cause and Disease-specific Mortality in the Korean Multi-center Cancer Cohort Study: Yohwan Yeo, Seung Hyun Ma, Sue Kyung Park, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo; J Prev Med Public Health. 2013;46(5):271-281. Published online September 30, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.5.271

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Abstract PDF

Objectives

Emerging evidence indicates that sleep duration is associated with health outcomes. However, the relationship of sleep duration with long-term health is unclear. This study was designed to determine the relationship of sleep duration with mortality as a parameter for long-term health in a large prospective cohort study in Korea.

Methods

The study population included 13 164 participants aged over 20 years from the Korean Multi-center Cancer Cohort study. Information on sleep duration was obtained through a structured questionnaire interview. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using a Cox regression model. The non-linear relationship between sleep duration and mortality was examined non-parametrically using restricted cubic splines.

Results

The HRs for all-cause mortality showed a U-shape, with the lowest point at sleep duration of 7 to 8 hours. There was an increased risk of death among persons with sleep duration of ≤5 hours (HR, 1.21; 95% CI, 1.03 to 1.41) and of ≥10 hours (HR, 1.36; 95% CI, 1.07 to 1.72). In stratified analysis, this relationship of HR was seen in women and in participants aged ≥60 years. Risk of cardiovascular disease-specific mortality was associated with a sleep duration of ≤5 hours (HR, 1.40; 95% CI, 1.02 to 1.93). Risk of death from respiratory disease was associated with sleep duration at both extremes (≤5 and ≥10 hours).

Conclusions

Sleep durations of 7 to 8 hours may be recommended to the public for a general healthy lifestyle in Korea.

Summary

Citations

Citations to this article as recorded by

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Interaction of Body Mass Index and Diabetes as Modifiers of Cardiovascular Mortality in a Cohort Study: Seung Hyun Ma, Bo-Young Park, Jae Jeong Yang, En-Joo Jung, Yohwan Yeo, Yungi Whang, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo, Sue Kyung Park; J Prev Med Public Health. 2012;45(6):394-401. Published online November 29, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.6.394

9,999 View
93 Download
13 Crossref

Abstract PDF

Objectives

Diabetes and obesity each increases mortality, but recent papers have shown that lean Asian persons were at greater risk for mortality than were obese persons. The objective of this study is to determine whether an interaction exists between body mass index (BMI) and diabetes, which can modify the risk of death by cardiovascular disease (CVD).

Methods

Subjects who were over 20 years of age, and who had information regarding BMI, past history of diabetes, and fasting blood glucose levels (n=16 048), were selected from the Korea Multi-center Cancer Cohort study participants. By 2008, a total of 1290 participants had died; 251 and 155 had died of CVD and stroke, respectively. The hazard for deaths was calculated with hazard ratio (HR) and 95% confidence interval (95% CI) by Cox proportional hazard model.

Results

Compared with the normal population, patients with diabetes were at higher risk for CVD and stroke deaths (HR, 1.84; 95% CI, 1.33 to 2.56; HR, 1.82; 95% CI, 1.20 to 2.76; respectively). Relative to subjects with no diabetes and normal BMI (21 to 22.9 kg/m²), lean subjects with diabetes (BMI <21 kg/m²) had a greater risk for CVD and stroke deaths (HR, 2.83; 95% CI, 1.57 to 5.09; HR, 3.27; 95% CI, 1.58 to 6.76; respectively), while obese subjects with diabetes (BMI ≥25 kg/m²) had no increased death risk (p-interaction <0.05). This pattern was consistent in sub-populations with no incidence of hypertension.

Conclusions

This study suggests that diabetes in lean people is more critical to CVD deaths than it is in obese people.

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Factors Affecting Social Distance toward Mental Illness: A Nationwide Telephone Survey in Korea.: Sangjun Moon, Jin Seok Lee, Sue Kyung Park, Sun Young Lee, Yoon Kim, Yong Ik Kim, Youngsoo Shin; J Prev Med Public Health. 2008;41(6):419-426.; DOI: https://doi.org/10.3961/jpmph.2008.41.6.419

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OBJECTIVE
The purpose of this study was to investigate impact of knowledge, familiarity, and prejudice about mental illness as well as demographic factors on the social distance from mentally ill people, which is a proxy measure of discrimination. METHOD: To assess the impact of knowledge and familiarity, prejudice about mental illness and demographic factors on the social distance from mental illness, we conducted a telephone survey in South Korea with the responders being nationally representative people who were 18 years old or over (n=1040). Independent samples T-tests, one way ANOVA and linear regression analysis were performed to analyze the results of the survey. RESULT: The social distance from mental illness decreased as the knowledge and familiarity increased, but the social distance was increased as prejudice was increased. Prejudice had a greater impact on social distance than familiarity and knowledge. Females showed greater social distance than did males. A higher education level had a negative effect on social distance. CONCLUSION: To reduce the social distance from mentally ill people, efforts to increase the familiarity about mental illness as well as efforts to educate people about mental illness are important.

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Reliability of a Questionnaire for Women's Reproductive History.: Kwang Pil Ko, Sue Kyung Park, Yeonju Kim, Jisuk Bae, Jae kwan Jun, Jin Gwack, Keun Young Yoo; J Prev Med Public Health. 2008;41(3):181-185.; DOI: https://doi.org/10.3961/jpmph.2008.41.3.181

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OBJECTIVES
This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. MATERIALS AND METHODS: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. RESULTS: The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. CONCLUSIONS: The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.

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Mario Romandini, Hye‐Sun Shin, Pierluigi Romandini, Andreina Laforí, Massimo Cordaro
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Mohammad Zakaria Pezeshki, Atefeh Shadman, Mahasti Alizadeh, Sevil Hakimi, Fariba Heidari
Journal of Caring Sciences.2017; 6(2): 183. CrossRef
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A. Shin, Y.-M. Song, K.-Y. Yoo, J. Sung
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Cigarette Smoking and Gastric Cancer Risk in a Community-based Cohort Study in Korea.: Yeonju Kim, Aesun Shin, Jin Gwack, Jae Kwan Jun, Sue Kyung Park, Daehee Kang, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo; J Prev Med Public Health. 2007;40(6):467-474.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.467

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OBJECTIVES
Gastric cancer is the most common incident cancer in Korea. Although Helicobacter pylori infection is the most important risk factor for the development of gastric cancer, cigarette smoking has also been suggested to play an important role in the development of gastric cancer. The objective of this study is to evaluate the relationship between cigarette smoking and gastric cancer risk in a Korean population. METHODS: The study population consisted of 13,785 subjects who had been enrolled in the Korean Multi-Center Cancer Cohort between 1993 and 2002. As of December 2002, 139 incident gastric cancer cases were ascertained through the Korea Central Cancer Registry and the National Death Certificate Database. Relative risks (RR) and 95% confidence intervals (CI) for gastric cancer were estimated using CoxZs proportional hazard model adjusted for age, education, alcohol drinking status and history of gastritis or ulcer. RESULTS: Significant dose-response relationships were observed between the duration of smoking and the risk of gastric cancer among the male subjects in comparison to non-smokers: men who smoked for 20-39 years had a 2.09- fold (95% CI 1.00-4.38) increase, and those who smoked for more than 40 years had a 3.13-fold (95% CI 1.59-6.17) increase in the risk of gastric cancer (Ptrend<0.01). CONCLUSIONS: This study suggests that a longer duration of cigarette smoking may increase the risk of gastric cancer development in a dose-response manner in Korean men. The association between smoking and gastric cancer risk in women should be verified in future studies with a larger number of cases.

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Delphine Praud, Matteo Rota, Claudio Pelucchi, Paola Bertuccio, Tiziana Rosso, Carlotta Galeone, Zuo-Feng Zhang, Keitaro Matsuo, Hidemi Ito, Jinfu Hu, Kenneth C. Johnson, Guo-Pei Yu, Domenico Palli, Monica Ferraroni, Joshua Muscat, Nuno Lunet, Bárbara Pel
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Minkyo Song, Hwi-Won Lee, Daehee Kang
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Amartya Roy, Jyotirmoy Sikdar, Paromita Seal, Rajen Haldar
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In-Seob Lee, Young-Soo Park, Jeong Hoon Lee, Ji Young Park, Hee-Sung Kim, Beom-Su Kim, Jeong-Hwan Yook, Sung-Tae Oh, Byung-Sik Kim
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Zhang MW, Jin MJ, Yu YX, Zhang SC, Liu B, Jiang X, Pan YF, Li QL, Ma XY, Chen K
Molecular Carcinogenesis.2012;[Epub] CrossRef
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Palanisamy Pasupathi, Ganesan Saravanan, Palanisamy Chinnaswamy, Govindaswamy Bakthavathsalam
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Cigarette Smoking, Alcohol Consumption, Tuberculosis and Risk of Lung Cancer: The Korean Multi-center Cancer Cohort Study.: Jisuk Bae, Jin Gwack, Sue Kyung Park, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo; J Prev Med Public Health. 2007;40(4):321-328.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.321

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OBJECTIVES
The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. METHODS: The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physiciandiagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. RESULTS: Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to noncases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (pinteraction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). CONCLUSIONS: Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.

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Lung Cancer.2011; 72(2): 258. CrossRef
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Lung cancer risk and cigarette smoking, lung tuberculosis according to histologic type and gender in a population based case–control study
Sue K. Park, Lisa Y. Cho, Jae Jeong Yang, Boyoung Park, Soung Hoon Chang, Kun-Sei Lee, Hyeongsu Kim, Keun-Young Yoo, Choon-Taek Lee
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Seasonal Variation of Food Intake in Food Frequency Questionnaire among Workers in a Nuclear Power Plant.: Jae Jeong Yang, Sue Kyung Park, Hyun Sul Lim, Kwang Pil Ko, Younjhin Ahn, Yoon Ok Ahn; J Prev Med Public Health. 2007;40(3):239-248.; DOI: https://doi.org/10.3961/jpmph.2007.40.3.239

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OBJECTIVES
This study was conducted to investigate the systematic error, such as seasonal change or inadequate food items, in a food frequency questionnaire administered to workers in a Nuclear Power Plant, Korea. METHODS: We performed three repeat-tests with 28 subjects on May 13, July 8 and Dec 16, 1992. Our food frequency questionnaire (FFQ) comprised 84 foods organized into 7 food-groups, and was composed of the items of usual intake frequency (8 categories) and the amount per intake (3 or 4 categories) over the previous year. We compared the means of intake frequency and the frequency of the portion-size according to each season using Repeated Measures ANOVA and Pearson's chisquare test with Fisher's exact test. RESULTS: We found the significant seasonal changes of several food items in intake frequency measurement. These items were typical seasonal foods such as mandarin orange, plum and green vegetables, while the single questions consisted of inadequate food items such as thick beef or similar soup and various kimchi products. Significant seasonal changes in portion-size were found in only two items: cooked rice-brown and fresh.frozen fishes. CONCLUSIONS: The systematic errors observed could caused loss of validity in the FFQ. Consideration should be given for seasonal variation in FFQ survey and methodological concerns are needed to improve the quality for measuring usual diet pattern.

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Fasting Serum Glucose and Subsequent Liver Cancer Risk in a Korean Prospective Cohort.: Jin Gwack, Seung Sik Hwang, Kwang Pil Ko, Jae Kwan Jun, Sue Kyung Park, Soung Hoon Chang, Hai Rim Shin, Keun Young Yoo; J Prev Med Public Health. 2007;40(1):23-28.; DOI: https://doi.org/10.3961/jpmph.2007.40.1.23

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OBJECTIVES
Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. METHODS: Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. RESULTS: The RRs of serum glucose for liver caner were 1.20 (95% CI=0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI=1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI=1.09-18.28) for those with glucose levels >100 mg/dL. CONCLUSIONS: The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.

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Jin-Kyoung Oh, Min Kyung Lim, E Hwa Yun, Min-Ho Choi, Sung-Tae Hong, Soung-Hoon Chang, Sue Kyung Park, Sung-Il Cho, Dong-Hyun Kim, Keun-Young Yoo, Hai-Rim Shin
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Attributable fraction of alcohol consumption on cancer using population-based nationwide cancer incidence and mortality data in the Republic of Korea
Sohee Park, Hai-Rim Shin, Boram Lee, Aesun Shin, Kyu-Won Jung, Duk-Hee Lee, Sun Ha Jee, Sung-Il Cho, Sue Kyung Park, Mathieu Boniol, Paolo Boffetta, Elisabete Weiderpass
BMC Cancer.2014;[Epub] CrossRef
Prediabetes and the risk of cancer: a meta-analysis
Yi Huang, Xiaoyan Cai, Miaozhen Qiu, Peisong Chen, Hongfeng Tang, Yunzhao Hu, Yuli Huang
Diabetologia.2014; 57(11): 2261. CrossRef
Serum glucose and risk of cancer: a meta-analysis
Danielle J Crawley, Lars Holmberg, Jennifer C Melvin, Massimo Loda, Simon Chowdhury, Sarah M Rudman, Mieke Van Hemelrijck
BMC Cancer.2014;[Epub] CrossRef
Recent evidence on alcohol and cancer epidemiology
Chiara Scoccianti, Kurt Straif, Isabelle Romieu
Future Oncology.2013; 9(9): 1315. CrossRef
Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study
Jin-Kyoung Oh, Hai-Rim Shin, Min Kyung Lim, Heeyoun Cho, Dong-Il Kim, Youngmee Jee, Haesun Yun, Keun-Young Yoo
BMC Cancer.2012;[Epub] CrossRef
Coinfection of hepatitis B and C viruses and risk of hepatocellular carcinoma: Systematic review and meta‐analysis
Lisa Y. Cho, Jae Jeong Yang, Kwang‐Pil Ko, Boyoung Park, Aesun Shin, Min Kyung Lim, Jin‐Kyoung Oh, Sohee Park, Yoon Jun Kim, Hai‐Rim Shin, Keun‐Young Yoo, Sue K. Park
International Journal of Cancer.2011; 128(1): 176. CrossRef

Fasting Serum Glucose Level and Gastric Cancer Risk in a Nested Case-control Study.: Jae Kwan Jun, Jin Gwack, Sue Kyung Park, Yun Hee Choi, Yeonju Kim, Aesun Shin, Soung Hoon Chang, Hai Rim Shin, Keun Young Yoo; J Prev Med Public Health. 2006;39(6):493-498.

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Diabetes has been reported as a risk factor for several cancers. However, the association between diabetes and gastric cancer has been inconsistent. The aim of this study was to evaluate the association between the fasting serum glucose level and gastric cancer risk in Korea. METHODS: Among the members of the Korean Multi-Center Cancer Cohort (KMCC) from 1993 to 2004, a total of 100 incident gastric cancer cases were ascertained until December 31, 2002 and 400 controls were matched according to age, sex, and year and area of enrollment. Of the eligible subjects, those without fasting serum glucose level information were excluded, with a total of 64 cases and 236 controls finally selected. On enrollment, all subjects completed a baseline demographic and lifestyle characteristics questionnaire, and had their fasting serum glucose level measured. The Helicobacter pylori infection status was determined by an immunoblot assay using longterm stored serum. The odds ratios (ORs) were estimated using conditional and unconditional logistic regression models adjusted for the H. pylori infection status, smoking, drinking, education, follow-up period and matching variables. RESULTS: The ORs for risk of gastric cancer according to the serum glucose level were 1.33 [95% CI=0.50-3.53] and 1.66 [95% CI=0.55-5.02] for the categories of 100-125 and 126 mg/dL or greater, respectively, compared to the category of less than 100 mg/dL. No increased risk of gastric cancer according to the serum glucose level was found (p-trend=0.337). CONCLUSIONS: This study provides no evidence for an association of the serum glucose level with gastric cancer.; Summary

A Study on Polymorphism Affecting Excretion of Urinary Methylhippuric Acid due to Xylene Exposure.: Cheong Sik Kim, Sang Baek Koh, Hyeongsu Kim, Sue Kyung Park, Soung Hoon Chang; J Prev Med Public Health. 2004;37(4):321-328. Published online November 30, 2004

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The purpose of this study was to investigate the effect of genetic polymorphism of cytochrome P450 2E1 (CYP2E1) and aldehyde dehydrogenase 2 (ALDH2) on the xylene metabolism. METHODS: Among 247 workers, 116 were occupationally exposed to xylene and 131 were not. Workers exposed to xylene had different work such as spray, touch-up, mix & assist, and pre-treat. Questionnaire variables were age, sex, use of personal protective equipment, smoking, previous night's drinking and work duration. The urinary methylhippuric acid was measured in the urine collected in the afternoon and corrected by urinary creatinine concentration. The genotypes of CYP2E1 and ALDH2 were investigated by using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) methods with DNA extracted from venous blood. RESULTS: 1. The urinary concentrations of o-, m-, and pmethylhippuric acid and total methylhippuric acid in the exposed group were significantly higher than those in the non-exposed group (p< 0.001). 2. In multiple regression analysis, the urinary methylhippuric acid concentration was significantly influenced by exposure grade (Job-exposure matrixes), smoking, drug use and kind of protective equipment (p< 0.1). 3. Genetic polymorphism of CYP2E1 and ALDH2 did not affect urinary methylhippuric acid level in the exposed group (p> 0.05). CONCLUSIONS: Exposure grade, smoking, drug use and kind of protective equipment affected urinary methylhippuric acid level, whereas genetic polymorphism of CYP2E1 and ALDH2 did not. However, further investigation for the effect of genetic polymorphism on the metabolism of xylene with a larger sample size is needed.; Summary

Assessment of DNA Viability in Long Term-Stored Buffy Coat Species for the Korean Multicenter Cancer Cohort.: Mihi Yang, Jihyun Yoo, Cheong Sik Kim, Aesun Shin, Daehee Kang, Soung Hoon Chang, Sue Kyung Park, Hai Rim Shin, Keun Young Yoo; Korean J Prev Med. 2003;36(4):373-376.

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Abstract PDF: OBJECTIVES
Peripheral blood-buffy coat fractions (N = 14, 956) have been stored at -70degrees C in the headquarter of the Korean Multicenter Cancer Cohort (KMCC), since 1993. To study the future molecular etiology of cancers using specimens of the cohort, properly stored specimens are necessary. Therefore, the DNA-viability of the buffy coat samples was investigated. METHODS: Buffy coat fraction samples were randomly selected from various collection areas and years (N = 100). The DNA viability was evaluate from the UV-absorbent ratios at 260/280nm and the PCR for beta-globin was performed with genomic DNA isolated from the buffy coat. RESULTS: PCR products were obtained from 85 and 98% of the C and H area-samples, respectively, using 50 or 100mul of the buffy coat. There were significant differences in the yields of the PCR-amplifications from the C and H areas (p < 0.05), which was due to differences in the homogenization of the buffy coat fractions available as aliquots. The PCR-products were obtained from all of the samples (N = 7) stored at the C area-local center, but the other aliquots stored at the headquarter were not PCR-amplified. Therefore, the PCR products in almost all the samples, even including the DNA-degraded samples, were obtained. In addition, an improvement in the DNA isolation, i.e. approx. 1.6 fold, was found after using extra RBC lysis buffer. CONCLUSIONS: PCR products for beta-globin were obtained from nearly all of the samples. The regional differences in the PCR amplifications were thought to have originated from the different sample-preparation and homogenization performance. Therefore, the long term-stored buffy coat species at the KMCC can be used for future molecular studies.; Summary

Assessment of the Availability of Health Insurance Data for Epidemiologic Study of Childhood Aseptic Meningitis.: Sue Kyung Park, Hae Kwan Cheong, Moran Ki, Young Mo Son, Ho Kim; Korean J Prev Med. 2003;36(4):349-358.

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Aseptic meningitis is a major cause of Korean childhood morbidity late spring and early summer. However, the nationwide incidences of the disease have not been reported. This study was conducted to evaluate the availability of National Health Insurance data (NHID) for the study of an epidemiological trend in the surveillance of aseptic meningitis in children. METHODS: All the claims, under A87, A87.8, and A87.9 by ICD-10, among children below 15 years of age, to the National Health Insurance Corporation, between January and December 1998, were extracted. A survey of the medical record of 3, 874 cases from 136 general hospitals was performed. The availability of the NHID was evaluated by the three following methods: 1) The diagnostic accuracy (the positive predictive value = proportion of the confirmed aseptic meningitis among the subjects registered as above disease-codes in NHID) was evaluated through a chart review, and according to age, gender, month and region of disease-occurrence. 2) The distribution of confirmed cases was compared with the distribution of total subjects from the NHID, for subjects in General hospitals, or the subjects surveyed. 3) The proportion of confirmed CSF test was confirmed, and the relating factor, which was the difference in CSF-test rate, analyzed. RESULTS: Among 3, 874 cases, CSF examinations were performed on 1, 845 (47.6%), and the CSF-test rates were different according to the medical utility (admission vs. OPD visit) and the severity of the symptoms and signs. The diagnostic accuracy for aseptic meningitis, and during the epidemic (May-Aug) and sporadic (Sept-Apr) periods, were 85.0 (1, 568/1, 845), 86.0 (1, 239/1, 440) and 81.2% (329/405), respectively. The distributions by age, sex, month or period (epidemic/sporadic) and region, in the confirmed cases, were similar to those in the NHID, in both the subjects at General hospitals and in those surveyed, to within +/-7%. CONCLUSIONS: In this paper, the NHID for the subjects registered with an aseptic meningitis disease-code might be available for an epidemiological study on the incidence-estimation of childhood aseptic meningitis, as the NHID could include both the probable and definite cases. On the basis of this result, further studies of time-series and secular trend analyses, using the NHID, will be performed.; Summary

A Neurobehavioral Performance Assessment in Lacunar Infarction Case-control Study.: Ham Gyum Kim, Soung Hoon Chang, Sue Kyung Park, Kun Sei Lee, Hyeong Su Kim, Wha Sun Kim; Korean J Prev Med. 2003;36(3):255-262.

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We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. METHODS: Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1: 1. Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test. RESULTS: Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, and systolic blood pressure. From multivariate regression analysis, there was significant difference (p< 0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. CONCLUSIONS: We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier detection for neurological abnormality in lacunar infarction.; Summary

Estimation of Joint Risks for Developing Uterine Cervix Cancer in Korea.: Hachung Yoon, Aesun Shin, Sue Kyung Park, Myung Jin Jang, Keun Young Yoo; Korean J Prev Med. 2002;35(3):263-268.

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This study was aiming at estimating the joint effects of various risk factors associated with uterine cervix cancer in Korea. METHODS: Data obtained from a case-control study were analyzed with a multiplicative model. RESULTS: After adjustment for age and husband's educational attainments, the family history of cervical cancer (OR=2.1, 95% CI=1.2-3.9), unstable marital status due to separation, by death or divorce, etc. (OR=2.8, 95% CI=1.7-4.6), and a large number of deliveries (> or = 3 vs. nulliparous OR=6.5, 95% CI=1.4-29.9) increased the risk of uterine cervix cancer. Conversely, first sexual intercourse at an older age (> or = 25 years vs. <19 years OR=0.4, 95% CI=0.2-0.6) and husband's circumcision (OR=0.7, 95% CI=0.5-1.0) decreased the risk. In the multiplicative model, the highest joint risk (OR=39.2, 95% CI 5.9-258.9) was observed in women with a family history of uterine cervical cancer, an unstable marital status, where the ex-husband was not circumcised, with 3 or more delivery experiences, and having her first sexual intercourse when younger than 19 years of age. However, women without a family history of uterine cervix cancer, married to a circumcised husband, having had her first sexual intercourse at 25 years or older, and nulliparous, showed the lowest joint effect (OR=0.3, 95% CI=0.1-0.5). CONCLUSION: As carcinogenesis is a complex action involving various factors, we consider a joint effects approach to be appropriate in an epidemiological study on risk factors for uterine cervix neoplasms.cervix neoplasm.; Summary

Evaluation of Measles Vaccine Effectiveness in a Community Outbreak.: Byung Chan Park, Hae Kwan Cheong, Sue Kyung Park; Korean J Prev Med. 2002;35(1):33-40.

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From an analysis of a community outbreak of measles in Youngju, Gyeongbuk, in March 2000, the authors evaluated the effectiveness of the measles vaccination and its determinants to provide an epidemiologic basis for the establishment of a vaccination policy. METHODS: Information was collected regarding the vaccinations from the health records of four primary schools and through a questionnaire survey of the parents of students in two middle and two high schools (N=4638). Measles cases were surveyed from the patient list of each school and from case reports in the public health center. The attack rate and vaccine effectiveness of measles was evaluated by school; grade; frequency, region, and institution of vaccination. RESULTS: The attack rate of measles, 6.3% among the total subjects, was higher in middle school students (15.8%) than in primary (2.0%, p<0.05) and high school students (8.9%, p<0.05). The attack rate of the unvaccinated group was 4.6-fold higher than the vaccinated group in primary schools (p<0.05). Vaccine effectiveness was 83.2% among lower graders of primary schools, 34.0% among higher graders of primary schools, 26.1% in middle schools, and -7.0% in high schools. In multiple logistic regression analysis, grade in school (odds ratio, 0.77; 95% CI=0.67-0.87) and frequency of vaccination (odds ratio, 0.57; 95% CI=0.37-0.88) were significant predictors of the outcome. CONCLUSIONS: We concluded that the explosive outbreak of measles in this area resulted from both inadequate vaccination coverage and secondary failure of vaccination. There was no evidence of any effect of the cold chain system on the vaccine failure.; Summary

Comparative Epidemiologic Survey of Measles in Two Primary Schools.: Sue Kyung Park, Jee Hee Kim, Joo Yeon Lee, Byoung Kuk Na, Woo Joo Kim, Hae Kwan Cheong; Korean J Prev Med. 2001;34(2):131-140.

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Abstract PDF: OBJECTIVES
During March-May, 2000, a measles outbreak occurred at Youngduk, Korea. This county is divided into two areas with different historical and socioeconomic background. The outbreak occurred in one of these areas. We conducted a comparative epidemiologic study on the two areas in order to evaluate the factors related to the epidemic. MATERIALS AND METHODS: We selected two groups, grades 3 and 5 in a primary schools in each area. We investigated outbreak-related factors using parent-questionnaires, the vaccination history from the students health record and the records concerning the recent measles-outbreak from the local health center. Serologic test on measles-IgG and -IgM antibody was done. RESULTS: The infection rate was 31.6% for the epidemic area and 3.7% for non-the epidemic area according to clinical or serological criteria (p<0.001). No difference was seen in the measles vaccination rate, residence at the time of vaccination or past measles infection history between the two areas. In the epidemic area, the attack rate for the 4-6 year-old MMR booster group(20.5%) was higher than the non-booster group(32.4%), but was not found significantly. Vaccine efficacy was 29.6% in the epidemic area and 87.0% in the non-epidemic area (p<0.001). The IgG level and positive rate were significantly different between the two areas (median 10727 IU/ml, 98.9% in epidemic area; median 346 IU/ml, 85.9% in the non-epidemic area, p<0.001). However, the IgG level and positive rate between the measles-cases and non-cases were not significantly different. CONCLUSIONS: This outbreak took place in mostly vaccinated children. These results suggest that a reduction of herd immunity for immunity failure after vaccination may be one of the feasible factors related to the outbreak pattern in the two areas. The results of the IgG level and positive rate suggest that re-establishment of a normal value for IgG level and of a qualitative method for IgG are needed.; Summary

Size of Prostatitis Symptoms Using Prostatitis Symptom Index(PSI): The Effect of Prostatitis Symptoms on Quality of Life.: Seok Soo Byun, Daehee Kang, Keun Young Yoo, Sue Kyung Park, Cheol Kwak, Moon Ki Jo, Hyeon Hoe Kim, Chongwook Lee; Korean J Prev Med. 2000;33(4):449-458.

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To determine the prevalence of prostatitis symptoms in the general population by questionnaire survey and to measure the effect of prostatitis symptoms on quality of life(QOL). MATERIALS AND METHODS: A cross sectional community-based epidemiologic study was performed on 2,034 men, living in the Seoul metropolitan area using stepwise random sampling. Out of 2,034 interviewees, 1,356 men who were older than 40 and provided sufficient information were selected for this study. The questionnaires were completed by well trained interviewers. Contents of the questionnaires included demographic data, the Prostatitis Symptom Index(PSI), the International Prostate Symptom Score(IPSS), a general health questionnaire section and a sexual health questionnaire section. The PSI was composed of a sum of the scores from three questions about dysuria, penile pain and perineal pain and it ranged 0 to 12. Incidence of prostatitis symptoms was defined by a score of 4 or more and the reference group was defined as consisting of those with a score of 3 or less. The rate of incidence of prostatitis symptoms was assessed according to age and the difference of QOL between the prostatitis symptoms group and the reference group. RESULTS: The overall positive rate of prostatitis symptoms measured by the PSI, in men older than 40, living in the Seoul metropolitan area, was 4.5%(61/1,356), adjusted to 4.8% by the relative proportion of this age group in the general population of the Seoul metropolitan area as compared to Korea and the World. The proportion of the group with prostatitis symptoms assessed by the PSI did not increase with age although the proportion of participants with moderate to severe lower urinary tract symptoms (LUTS) did increase with age. The group with prostatitis symptoms suffered from a much greater incidence of LUTS compared to the reference group (p<0.05). The QOL scores of the IPSS, and the general health and sexual health status of the group with prostatitis symptoms, were worse than those of the reference group.(p<0.05). CONCLUSIONS: The positive rate of prostatitis symptoms in men older than 40, living in the Seoul metropolitan area, was 4.8% and it didn't increase with age. The general QOL of the group with prostatitis symptoms was much worse than that of the reference group.; Summary

Incidence of Female Breast Cancer in a Defined Area in Korea.: Keun Young Yoo, Sue Kyung Park, Joo Hon Sung, Dong Young Noh, Kuk Jin Choe; Korean J Prev Med. 1998;31(4):592-603.

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Abstract PDF: This study was conducted to estimate incidence rate of female breast cancer in a defined area of Chungchongbuk-do in Korea. The presumptive breast cancer cases were selected from two different sources, i.e., medical utilization database of the National Health Insurance Corporation and the database from the National Cancer Registry. Medical students visited each hospital where the presumptive cases had been treated as a breast cancer patient, and made a dictation of medical record of each patient based on the claims stored in the Insurance Corporation from January to December 1995. The diagnoses in the claims included one of the following diagnostic codes; ICD-9 174-175(malignant neoplasms of the breast), 233(carcinoma in situ of the breast and genito-urinary system)or ICD-10 C50(malignant neoplasms of the breast), D05(carcinoma in situ of the breast and genito-urinary system). Each case has been confirmed as having a breast cancer by a breast surgeon through a medical record review. Age-standardized incidence rate of female breast cancer to the Korean population was estimated to be 10.5(95%confidence interval : 8.1-12.9)per 100,000 persons in 1995. Age-standardized rate to the world population was 9.8 per 100,000 persons, and the truncated rate for ages 35-64 was 27.2 per 100,000 persons. Validity of these estimates is discussing in comparison with previous methods of incidence estimation in Korea.; Summary

The Estimation of Prevalence of Diabetes Mellitus in a Rural Adult Population.: Sue Kyung Park, Joung Soon Kim; Korean J Prev Med. 1996;29(3):483-494.

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Abstract PDF: The objectives of this study are to estimate the prevalence of diabetes mellitus(DM) and to identify risk factors associated with fasting blood sugar in a rural adult population. We carried out a cross-sectional study on the residents over 30-year old. Among the 1077 eligible subjects, 725 persons responded to the study; the study consisted of interview on family and past history of DM, anthropometry, blood pressure, and blood sugar level in each subjects. Only 707 subjects of 725 participants had fasting blood sugar(FBS) examined and the rest, 18 subjects were had casual blood sugar examined due to failure of fasting over 8-hour. When subjects had FBS >or= 140mg/dl, 2 hours postprandial blood sugar level was checked after 75g oral glucose loading. The prevalence of DM was 8.9%, and age standardized prevalence rate adjusted to Korean population of 1995 was 5.8%. Mean and SD of fasting blood sugar in men was 99.8 +/- 22.6, and in women was 111.5 +/- 29.9. Mean levels of fasting blood sugar were significantly higher in women than in man and as their ages advanced the prevalencies in creased in both sexes. PP2 blood sugar levels were significantly higher in elder age and in persons with higher FBS levels than others. The risk factors associated with FBS were past history of diabetes, sex, socioeconomic status and waist-to-hip circumference ratio; the risk of diabetes was increased in female, people with past DM history, central obesity and low socioeconomic state. The low socioeconomic status associated with DM in this study, which is different from other study results, should be pursued in further studies.; Summary

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