Journal of Preventive Medicine and Public Health

Il Suh

31 Articles

C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population: Jung Hyun Lee, Hyungseon Yeom, Hyeon Chang Kim, Il Suh, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin, Sang-Baek Koh, Song Vogue Ahn, Tae-Yong Lee, So Yeon Ryu, Jae-Sok Song, Hong-Soon Choe, Young-Hoon Lee, Bo Youl Choi; J Prev Med Public Health. 2016;49(5):275-287. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.025

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Objectives
C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea.
Methods
A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant’s vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors.
Results
The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality.
Conclusions
Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.

Summary

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Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study
Ju-Yeun Lee, Ji Hoon Hong, Sangjun Lee, Seokyung An, Aesun Shin, Sue K. Park, Tariq Jamal Siddiqi
PLOS ONE.2022; 17(6): e0270510. CrossRef
Association of serum high-sensitivity C reactive protein with risk of mortality in an Asian population: the Health Examinees cohort
Sang-Ah Lee, Sung Ok Kwon, Hyerim Park, Xiao-Ou Shu, Jong-Koo Lee, Daehee Kang
BMJ Open.2022; 12(7): e052630. CrossRef
Associations of C-reactive protein and fibrinogen with mortality from all-causes, cardiovascular disease and cancer among U.S. adults
Junxiu Liu, Yanan Zhang, Carl J. Lavie, Fred K. Tabung, Jiting Xu, Qingwei Hu, Lixia He, Yunxiang Zhang
Preventive Medicine.2020; 139: 106044. CrossRef
Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey
Se-Won Park, Seong-Sik Park, Eun-Jung Kim, Won-Suk Sung, In-Hyuk Ha, Boyoung Jung
Health and Quality of Life Outcomes.2020;[Epub] CrossRef

The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population: Hyungseon Yeom, Jung Hyun Lee, Hyeon Chang Kim, Il Suh; J Prev Med Public Health. 2016;49(2):108-117. Published online March 23, 2016; DOI: https://doi.org/10.3961/jpmph.15.062

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Abstract PDF Supplementary Material

Objectives
Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy.
Methods
We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A “former smoker” was a patient who smoked only before receiving his diagnosis of diabetes. A “continuing smoker” was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m²). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked.
Results
Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29).
Conclusions
Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

Summary

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Framework of Guidelines for Management of CKD in Asia
Carol Pollock, Ju-young Moon, Le Pham Ngoc Ha, Pongsathorn Gojaseni, Chen Hua Ching, Lynn Gomez, Tak Mao Chan, Ming-Ju Wu, See Cheng Yeo, Pringgodigdo Nugroho, Anil Kumar Bhalla
Kidney International Reports.2024; 9(4): 752. CrossRef
Relating Onset of Health Conditions to Changes in Tobacco/Nicotine Use — Analyses based on the U.S. PATH Study *
Peter N. Lee, John S. Fry
Contributions to Tobacco & Nicotine Research.2023; 32(1): 1. CrossRef
Nicotine promotes renal interstitial fibrosis via upregulation of XIAP in an alpha7-nAChR-dependent manner
Lili Guo, Yue Zhang, Jian Lu, Xiaoyang Li, Chao Zhang, Wenzhu Song, Yafang Dong, Xiangyang Zhou, Rongshan Li
Molecular and Cellular Endocrinology.2023; 576: 111989. CrossRef
Lifestyle factors associated with a rapid decline in the estimated glomerular filtration rate over two years in older adults with type 2 diabetes–Evidence from a large national database in Japan
Yaya Li, Makoto Fujii, Yuko Ohno, Asuka Ikeda, Kayo Godai, Yuko Nakamura, Yuya Akagi, Daisuke Yabe, Kazuyo Tsushita, Naoki Kashihara, Kei Kamide, Mai Kabayama, Patricia Khashayar
PLOS ONE.2023; 18(12): e0295235. CrossRef
Development of a Risk Model for Predicting Microalbuminuria in the Chinese Population Using Machine Learning Algorithms
Wei Lin, Songchang Shi, Huibin Huang, Nengying Wang, Junping Wen, Gang Chen
Frontiers in Medicine.2022;[Epub] CrossRef
The Global Burden of Type 2 Diabetes Attributable to Tobacco: A Secondary Analysis From the Global Burden of Disease Study 2019
Jianjun Bai, Fang Shi, Yudiyang Ma, Donghui Yang, Chuanhua Yu, Jinhong Cao
Frontiers in Endocrinology.2022;[Epub] CrossRef
ASIAN PACIFIC SOCIETY OF NEPHROLOGY CLINICAL PRACTICE GUIDELINE ON DIABETIC KIDNEY DISEASE
Adrian LIEW, Sunita BAVANANDAN, Narayan PRASAD, Muh Geot WONG, Jer Ming CHANG, Somchai EIAM‐ONG, Chuan‐Ming HAO, Chiao Yuen LIM, Soo Kun LIM, Kook‐Hwan OH, Hirokazu OKADA, Paweena SUSANTITAPHONG, Aida LYDIA, Huong Thi Bich TRAN, Russell VILLANUEVA, See Ch
Nephrology.2020; 25(S2): 12. CrossRef
Impacts of Preoperative Smoking and Smoking Cessation Time on Preoperative Peripheral Blood Inflammatory Indexes and Postoperative Hospitalization Outcome in Male Patients with Lung Cancer and Surgery Treatment
Xu Longming, Dai Shuiping, Zuo Yunxia
Chinese Medical Sciences Journal.2020; 35(2): 170. CrossRef
Interaction of MTHFR C677T polymorphism with smoking in susceptibility to diabetic nephropathy in Chinese men with type 2 diabetes
Liang Ma, Yongwei Jiang, Xiaomu Kong, Qian Liu, Hailing Zhao, Tingting Zhao, Yongtong Cao, Ping Li
Journal of Human Genetics.2019; 64(1): 23. CrossRef
Le tabagisme actif : un facteur de risque majeur des maladies non transmissibles humaines dans une enquête hospitalière
H. Ben Ayed, M. Ben Hmida, M. Ben Jemaa, M. Trigui, J. Jedidi, R. Karray, Y. Mejdoub, M. Kassis, H. Feki, S. Yaich, J. Damak
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Association of smoking and cardiometabolic parameters with albuminuria in people with type 2 diabetes mellitus: a systematic review and meta-analysis
Debasish Kar, Clare Gillies, Mintu Nath, Kamlesh Khunti, Melanie J. Davies, Samuel Seidu
Acta Diabetologica.2019; 56(8): 839. CrossRef
The global prevalence of tobacco use in type 2 diabetes mellitus patients: A systematic review and meta-analysis
Peter Roderick, Victoria Turner, Anne Readshaw, Omara Dogar, Kamran Siddiqi
Diabetes Research and Clinical Practice.2019; 154: 52. CrossRef
Cigarette smoking and risk of albuminuria in patients with type 2 diabetes: a systematic review and meta-analysis of observational studies
Haili Xu, Jinliu Suo, Jing Lian
International Urology and Nephrology.2018; 50(5): 911. CrossRef
Cigarette smoking and chronic kidney disease in the general population: a systematic review and meta-analysis of prospective cohort studies
Jia Xia, Lin Wang, Zhiheng Ma, Liping Zhong, Ying Wang, Yachan Gao, Liqun He, Xiao Su
Nephrology Dialysis Transplantation.2017; 32(3): 475. CrossRef
Smoking and the risk of diabetic nephropathy in patients with type 1 and type 2 diabetes: a meta-analysis of observational studies
Ning Jiang, Feng Huang, Xiurong Zhang
Oncotarget.2017; 8(54): 93209. CrossRef
Association of single-nucleotide polymorphisms in the RAGE gene and its gene- environment interactions with diabetic nephropathy in Chinese patients with type 2 diabetes
Ying Zhang, Nan Jia, Feng Hu, Naijun Fan, Xiaohua Guo, Han Du, Changlin Mei, Chunfang Gao
Oncotarget.2017; 8(57): 96885. CrossRef

Association Between Serum Uric Acid Level and Metabolic Syndrome: Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh; J Prev Med Public Health. 2012;45(3):181-187. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.181

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Abstract PDF

Objectives

Serum uric acid levels have been reported to be associated with a variety of cardiovascular conditions. However, the direct association between uric acid levels and metabolic syndrome remains controversial. Thus, we evaluated the association of serum uric acid levels and metabolic syndrome in a community-based cohort study in Korea.

Methods

We performed cross-sectional analysis of baseline data of 889 males and 1491 females (aged 38 to 87) who participated in baseline examinations of the Korean Genome and Epidemiology Study: Kanghwa study. Blood samples were collected after at least an 8 hour fast. Uric acid quartiles were defined as follows: <4.8, 4.8-<5.6, 5.6-<6.5, ≥6.5 mg/dL in males; and <3.8, 3.8-<4.3, 4.3-<5.1, ≥5.1 mg/dL in females. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III Criteria with adjusted waist circumference cutoffs (90 cm for males; 80 cm for females). The association between serum uric acid quartiles and metabolic syndrome was assessed using multivariate logistic regression.

Results

The odds ratio for having metabolic syndrome in the highest versus lowest quartiles of serum uric acid levels was 2.67 (95% confidence interval [CI], 1.60 to 4.46) in males and 2.14 (95% CI, 1.50 to 3.05) in females after adjusting for age, smoking, alcohol intake, body mass index, total cholesterol, HbA1c, albumin, γ-glutamyltransferase, blood urea nitrogen, and log C-reactive protein. The number of metabolic abnormalities also increased gradually with increasing serum uric acid levels (adjusted p for trend < 0.001 in both sexes).

Conclusions

Higher serum uric acid levels are positively associated with the presence of metabolic syndrome in Korean males and females.

Summary

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The Association Between Serum Albumin Levels and Metabolic Syndrome in a Rural Population of Korea: Hye Min Cho, Hyeon Chang Kim, Ju-Mi Lee, Sun Min Oh, Dong Phil Choi, Il Suh; J Prev Med Public Health. 2012;45(2):98-104. Published online March 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.2.98

11,030 View
106 Download
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Abstract PDF

Objectives

A positive association between serum albumin levels and metabolic syndrome has been reported in observation studies, but it has not been established in the Korean population. The purpose of this study was to evaluate the association between serum albumin levels and the presence of metabolic syndrome among a sample of apparently healthy Korean adults.

Methods

This cross-sectional study analyzed data of 3189 community-dwelling people (1189 men and 2000 women) who were aged 40 to 87 years and were living in a rural area in Korea. Serum albumin levels were classified into quartile groups for each sex. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with an adjusted waist circumference cut-off value (≥90 cm for men and ≥85 cm for women). An independent association between serum albumin levels and metabolic syndrome was assessed by multiple logistic regression analysis.

Results

Higher serum albumin levels were associated with increased prevalence of metabolic syndrome. The odds ratio (95% confidence interval) of the prevalence of metabolic syndrome for the highest versus the lowest serum albumin quartiles was 2.81 (1.91 to 4.14) in men and 1.96 (1.52 to 2.52) in women, after adjusting for age, smoking status, alcohol consumption, and physical activity. When each metabolic abnormality was analyzed separately, higher serum albumin levels were significantly associated with hypertriglyceridemia and hyperglycemia in both sexes, and with abdominal obesity in men.

Conclusions

These results suggest that higher serum albumin levels are positively associated with an increased risk of metabolic syndrome in Korean adults.

Summary

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Association Between Meat Consumption and Carotid Intima-Media Thickness in Korean Adults with Metabolic Syndrome.: Sun Min Oh, Hyeon Chang Kim, Song Vogue Ahn, Hye Jin Chi, Il Suh; J Prev Med Public Health. 2010;43(6):486-495.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.486

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OBJECTIVES
The effect of meat consumption on cardiometabolic risk has been continuously studied, but their associations are not conclusive. The aim of this study is to examine the association between the consumption of meat or red meat and carotid intima-media thickness (IMT) in healthy Korean adults. METHODS: This study evaluated 2374 community-dwelling adults (933 men and 1441 women) who were free of cardiovascular disease or cancer, living in a rural area in Korea. Total meat and red meat intakes were assessed with a validated 103 item-food frequency questionnaire. Carotid IMT was evaluated ultrasonographically, IMTmax was defined as the highest value among IMT of bilateral common carotid arteries. RESULTS: After adjustment for potential confounding factors, the mean IMTmax tended to increase in higher meat consumption groups in both men and women with metabolic syndrome (p for trend= 0.027 and 0.049, respectively), but not in participants without metabolic syndrome. Frequent meat consumption (> or =5 servings/week) was significantly associated with higher IMTmax in men with metabolic syndrome (by 0.08 mm, p=0.015). Whereas, the association was not significant in women (by 0.05 mm, p=0.115). Similar but attenuated findings were shown with red meat intake. CONCLUSIONS: Our findings suggest that a higher meat consumption may be associated with a higher carotid IMT in Korean adults with metabolic syndrome. The frequent meat consumption (> or =5 servings/week), compared with the others, was associated with a higher carotid IMTmax only in men with metabolic syndrome. Further research is required to explore optimal meat consumption in people with specific medical conditions.

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Intake of food rich in saturated fat in relation to subclinical atherosclerosis and potential modulating effects from single genetic variants
Federica Laguzzi, Buamina Maitusong, Rona J. Strawbridge, Damiano Baldassarre, Fabrizio Veglia, Steve E. Humphries, Rainer Rauramaa, Sudhir Kurl, Andries J. Smit, Philippe Giral, Angela Silveira, Elena Tremoli, Anders Hamsten, Ulf de Faire, Bruna Gigante,
Scientific Reports.2021;[Epub] CrossRef
The Relationship Between Dietary Choices and Health and Premature Vascular Ageing
Ioana Mozos, Daniela Jianu, Dana Stoian, Costin Mozos, Cristina Gug, Marius Pricop, Otilia Marginean, Constantin Tudor Luca
Heart, Lung and Circulation.2021; 30(11): 1647. CrossRef
Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults
Saerom Shin, Seungmin Lee
Korean Journal of Community Nutrition.2020; 25(1): 61. CrossRef
Association between Total Diet Quality and Metabolic Syndrome Incidence Risk in a Prospective Cohort of Korean Adults
Saerom Shin, Seungmin Lee
Clinical Nutrition Research.2019; 8(1): 46. CrossRef
Red meat consumption and cardiovascular target organ damage (from the Strong Heart Study)
Bernhard Haring, Wenyu Wang, Amanda Fretts, Daichi Shimbo, Elisa T. Lee, Barbara V. Howard, Mary J. Roman, Richard B. Devereux
Journal of Hypertension.2017; 35(9): 1794. CrossRef
The Strong Heart Study
José R. Banegas, Fernando Rodríguez-Artalejo
Journal of Hypertension.2017; 35(9): 1782. CrossRef
Association between Nitrogen Stable Isotope Ratios in Human Hair and Serum Levels of Leptin
Song Vogue Ahn, Sang-Baek Koh, Kwang-Sik Lee, Yeon-Sik Bong, Jong-Ku Park
The Tohoku Journal of Experimental Medicine.2017; 243(2): 133. CrossRef
The association between carbon and nitrogen stable isotope ratios of human hair and metabolic syndrome
Jong-Ku Park, Song Vogue Ahn, Mi Kyung Kim, Kwang-Sik Lee, Sang-Baek Koh, Yeon-Sik Bong
Clinica Chimica Acta.2015; 450: 72. CrossRef
Mediterranean diet and carotid atherosclerosis in the Northern Manhattan Study
Hannah Gardener, Clinton B. Wright, Digna Cabral, Nikolaos Scarmeas, Yian Gu, Ken Cheung, Mitchell S.V. Elkind, Ralph L. Sacco, Tatjana Rundek
Atherosclerosis.2014; 234(2): 303. CrossRef
Association Between Serum Uric Acid Level and Metabolic Syndrome
Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh
Journal of Preventive Medicine and Public Health.2012; 45(3): 181. CrossRef

C-reactive Protein and Carotid Intima-media Thickness in a Population of Middle-aged Koreans.: Mina Suh, Joo Young Lee, Song Vogue Ahn, Hyeon Chang Kim, Il Suh; J Prev Med Public Health. 2009;42(1):29-34.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.29

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OBJECTIVES
This study was performed to evaluate the relationship between C-reactive protein (CRP) and carotid intima-media thickness (carotid IMT) in a population of middle-aged Koreans. METHODS: A total of 1,054 men and 1,595 women (aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause (women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. RESULTS: Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women (p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men (p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women (p for trend=0.017), but not in men (p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55 (95% CI=1.06-2.26) in women, but only 1.05 (95% CI=0.69-1.62) in men. CONCLUSIONS: CRP and carotid IMT levels appear to be directly related in women, but not in men.

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Hematocrit Values Predict Carotid Intimal-Media Thickness in Obese Patients With Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study
Giovanni Tarantino, Luigi Barrea, Domenico Capone, Vincenzo Citro, Teresa Mosca, Silvia Savastano
Frontiers in Endocrinology.2018;[Epub] CrossRef
Association Between Serum Uric Acid Level and Metabolic Syndrome
Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh
Journal of Preventive Medicine and Public Health.2012; 45(3): 181. CrossRef
Relationships between high-sensitive C-reactive protein and markers of arterial stiffness in hypertensive patients. Differences by sex
Manuel A Gomez-Marcos, Jose I Recio-Rodríguez, Maria C Patino-Alonso, Cristina Agudo-Conde, Leticia Gomez-Sanchez, Emiliano Rodriguez-Sanchez, Marta Gomez-Sanchez, Vicente Martinez-Vizcaino, Luis Garcia-Ortiz
BMC Cardiovascular Disorders.2012;[Epub] CrossRef

Association between Hypertension and Pulmonary Function in Rural Adults in Korea.: Joo Young Lee, Song Vogue Ahn, Dong Phil Choi, Mina Suh, Hyeon Chang Kim, Young Sam Kim, Il Suh; J Prev Med Public Health. 2009;42(1):21-28.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.21

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OBJECTIVES
Whilst hypertension exerts a negative effect on several organs there have been few studies regarding its effect on pulmonary function. The objective of this study was to examine the relationship between hypertension and pulmonary function in rural Korean adults. METHODS: In 2006, 2534 people were recruited, aged 40 to 70, in Kangwha County. We selected 1454 (male: 624, female: 830) participants whose pulmonary function results were repeatable. Blood pressure (BP) was measured twice and the average calculated. Participants were divided into two groups (hypertensive group and non-hypertensive group) in accordance with The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Pulmonary function was measured by dry rolling seal spirometry. Forced expiratory volume in the one second and forced vital capacity were converted into percent-predicted values based on average pulmonary function amongst Koreans. RESULTS: The number of hypertensive participants in the present study was 460 (male: 205, female: 255) and the number of non-hypertensive participants was 994 (male: 419, female: 575). Our findings have shown that the mean values for expiratory volume in the one second and forced vital capacity were significantly lower for hypertensive people than for non-hypertensive people, among women (P=0.002 for forced expiratory volume in the one second, P<0.001 for forced vital capacity volume). Odds ratio analysis revealed that hypertensive participants were more likely to have lower pulmonary function than non-hypertensive participants, again significantly among women. CONCLUSIONS: The pulmonary function of hypertensive women was significantly lower than that of non-hypertensive women aged 40-70.

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Comparison between Tai Chi and square dance on the antihypertensive effect and cardiovascular disease risk factors in patients with essential hypertension: a 12-week randomized controlled trial
Zhi-Wei YAN, Zhen YANG, Jing-Hui YANG, Cheng-Lin SONG, Zhuang ZHAO, Yan GAO
The Journal of Sports Medicine and Physical Fitness.2022;[Epub] CrossRef
The association between the metabolic syndrome and metabolic syndrome score and pulmonary function in non-smoking adults
Hyun Yoon, Mi Young Gi, Ju Ae Cha, Chan Uk Yoo, Sang Muk Park
Diabetes and Vascular Disease Research.2018; 15(2): 131. CrossRef
Cardiovascular disease risk in people with spinal cord injury: is there a possible association between reduced lung function and increased risk of diabetes and hypertension?
B F Köseoğlu, V B Safer, Ö Öken, S Akselim
Spinal Cord.2017; 55(1): 87. CrossRef
Association between changes in systolic blood pressure and incident diabetes in a community-based cohort study in Korea
Seung Won Lee, Hyeon Chang Kim, Ju-mi Lee, Young Mi Yun, Joo Young Lee, Il Suh
Hypertension Research.2017; 40(7): 710. CrossRef
Association between stressful life events and resting heart rate
Ju-Mi Lee, Hyeon Chang Kim, Jee In Kang, Il Suh
BMC Psychology.2014;[Epub] CrossRef
Association Between Serum Uric Acid Level and Metabolic Syndrome
Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh
Journal of Preventive Medicine and Public Health.2012; 45(3): 181. CrossRef

The Association between Obesity Indices in Adolescence and Carotid Intima-media Thickness in Young Adults: Kangwha Study.: Yoo Jung Lee, Chung Mo Nam, Hyeon Chang Kim, Nam Wook Hur, Il Suh; J Prev Med Public Health. 2008;41(2):107-114.; DOI: https://doi.org/10.3961/jpmph.2008.41.2.107

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OBJECTIVES
The aim of this study is to investigate the association between obesity indices (body mass index, weight, waist-hip ratio and waist circumference) in adolescents and the carotid intima-media thickness (C-IMT) in early adulthood. We also wanted to identify the best predictor for C-IMT among these obesity indices. METHODS: This study used community-based prospective cohort study, known as the Kangwha Study, and the data we used were from subjects who were 16-years old in 1996 (defined as "adolescencec") and 25 years-old in 2005 (defined as "early adulthoodc"). The 256 subjects (113 men and 143 women) who were used for analysis participated in both follow-ups, and they underwent B-mode ultrasonography of the carotid arteries at the early adulthood follow-up. Obesity indices were defined as the body mass index, weight, waist-hip ratio and waist circumference. The C-IMT was defined as the mean of the maximal IMT of each common carotid artery. The C-IMT and obesity indices associations were evaluated via multivariable regression, logistic regression and the receiver-operator characteristic curve analyses. RESULTS: In men, all the obesity indices in adolescence were showed to have statistically significant positive association with C-IMT in early adulthood. However, no such relationship was showed in women. On multiple regression and logistic regression analysis, the waist-hip ratio showed the biggest relationship with the C-IMT among the 4 obesity indices. However, there were no statistical significant differences and no best predictor was found. For the women, the obesity incidences and C-IMT showed no relationships. CONCLUSIONS: This study suggested that obesity in adolescence was related to an increase C-IMT in healthy young Korean men.

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Application of Standardized Regression Coefficient in Meta-Analysis
Pentti Nieminen
BioMedInformatics.2022; 2(3): 434. CrossRef
Comparison analysis of childhood body mass index cut-offs in predicting adulthood carotid intima media thickness: Tehran lipid and glucose study
Farhad Hosseinpanah, Amirhosein Seyedhoseinpour, Maryam Barzin, Maryam Mahdavi, Erfan Tasdighi, Pooneh Dehghan, Amin Momeni Moghaddam, Fereidoun Azizi, Majid Valizadeh
BMC Pediatrics.2021;[Epub] CrossRef
Asian Cohort Studies on Cardiovascular Risk Factors in Childhood
Sun Jae Jung, Hyeon Chang Kim, Il Suh
Cardiovascular Prevention and Pharmacotherapy.2019; 1(1): 3. CrossRef
Carotid intima media thickness in obese children: is there an association with hyperlipidemia?
Zehra Esra Önal, Levent Soydan, Hatice Eren Öztürk, Çiğdem Sağ, Tamay Gürbüz, Çağatay Nuhoğlu, Mehmet Masum Şimşek
Journal of Pediatric Endocrinology and Metabolism.2016;[Epub] CrossRef
Analysis for the Patterns of Medical Care Utilization during 19 Years (1990-2008) and Its Related Factors in Hypertensive Patients Using National Patient Survey in Korea
Nam Wook Hur, Hyeon Chang Kim
Journal of the Korean Society of Hypertension.2014; 20(1): 8. CrossRef
Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome
Hye Ah Lee, Hyesook Park
Journal of Preventive Medicine and Public Health.2013; 46(4): 173. CrossRef
Longitudinal Standards for Height and Height Velocity in Korean Children and Adolescents: the Kangwha Cohort Study
Hyun Wook Chae, Il Suh, Ah Reum Kwon, Ye Jin Kim, Yong Hyuk Kim, Dae Ryong Kang, Ha Yan Kim, Sun Min Oh, Hyeon Chang Kim, Duk Hee Kim, Ho-Seong Kim
Journal of Korean Medical Science.2013; 28(10): 1512. CrossRef
Clinical characteristics of obese boys and girls in a high school: focused on abdominal fat indices, fatty liver and carotid intima-media thickness
Jung Eun Oh, Jiyoung Jung, Hae Soon Kim, Young Mi Hong, Jung Hyun Yoo, Young Whan Song, Jo Won Jung, Nam Su Kim, Chung Il Noh
Korean Journal of Pediatrics.2011; 54(7): 292. CrossRef
Association between Blood Pressure and Carotid Intima-Media Thickness
Sun Min Lim, Hyeon Chang Kim, Hoon Sang Lee, Joo Young Lee, Mina Suh, Song Vogue Ahn
The Journal of Pediatrics.2009; 154(5): 667. CrossRef

Impact of Multiple Cardiovascular Risk Factors on the Carotid Intima-media Thickness in Young Adults: The Kangwha Study.: Hoo Sun Chang, Hyeon Chang Kim, Song Vogue Ahn, Nam Wook Hur, Il Suh; J Prev Med Public Health. 2007;40(5):411-417.; DOI: https://doi.org/10.3961/jpmph.2007.40.5.411

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OBJECTIVES
Although risk factors for coronary artery disease are also associated with increased carotid intima-media thickness (IMT), there is little information available on the asymptomatic, young adult population. We examined the association between multiple cardiovascular risk factors and the common carotid IMT in 280 young Korean adults. METHODS: The data used for this study was obtained from 280 subjects (130 men and 150 women) aged 25 years who participated in the Kangwha Study follow-up examination in 2005. We measured cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry, carotid ultrasonography, and reviewed questionnaires on health behaviors. Risk factors were defined as values above the sex-specific 75th percentile of systolic blood pressure, body mass index, total cholesterol/high-density lipoprotein cholesterol ratio, fasting blood glucose and smoking status. RESULTS: The mean carotid IMT+/-standard deviation observed was 0.683+/-0.079 mm in men and 0.678+/-0.067 mm in women (p=0.567) and the evidence of plaque was not observed in any individuals. Mean carotid IMT increased with an increasing number of risk factors(p for trend <0.001) and carotid IMT values were 0.665 mm, 0.674 mm, 0.686 mm, 0.702 mm, and 0.748 mm for 0, 1, 2, 3, and 4 to 5 risk factors, respectively. The odds ratio for having the top quartile carotid IMT in men with 3 or more risk factors versus 0-2 risk factors was 5.09 (95% CI, 2.05-12.64). CONCLUSIONS: Current findings indicate the need for prevention and control of cardiovascular risk factors in young adults and more focus on those with multiple cardiovascular risk factors.

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Association Between Risk Factors in Childhood and Sex Differences in Prevalence of Carotid Artery Plaques and Intima‐Media Thickness in Mid‐Adulthood in the Childhood Determinants of Adult Health Study
Mohammad Shah, Marie‐Jeanne Buscot, Jing Tian, Hoang T. Phan, Brooklyn J. Fraser, Thomas H. Marwick, Terence Dwyer, Alison Venn, Seana Gall
Journal of the American Heart Association.2023;[Epub] CrossRef
Association between Fibrinogen and Carotid Atherosclerosis According to Smoking Status in a Korean Male Population
Hye Min Cho, Dae Ryong Kang, Hyeon Chang Kim, Sun Min Oh, Byeong-Keuk Kim, Il Suh
Yonsei Medical Journal.2015; 56(4): 921. CrossRef
Myocardial perfusion and intima-media thickness in patients with subclinical hypothyroidism
M Knapp, A Lisowska, B Sobkowicz, A Tycińska, R Sawicki, WJ Musiał
Advances in Medical Sciences.2013; 58(1): 44. CrossRef
Association between Depressive Symptoms and Bone Stiffness Index in Young Adults: The Kangwha Study
Sun Min Oh, Hyeon Chang Kim, Kyoung Min Kim, Song Vogue Ahn, Dong Phil Choi, Il Suh, Chih-Hsin Tang
PLoS ONE.2013; 8(7): e69929. CrossRef
The importance of intima-media thickness (IMT) measurements in monitoring of atherosclerosis progress after myocardial infarction
A Lisowska, M Knapp, S Bolińska, P Lisowski, A Krajewska, B Sobkowicz, WJ Musiał
Advances in Medical Sciences.2012; 57(1): 112. CrossRef
Association between Blood Pressure and Carotid Intima-Media Thickness
Sun Min Lim, Hyeon Chang Kim, Hoon Sang Lee, Joo Young Lee, Mina Suh, Song Vogue Ahn
The Journal of Pediatrics.2009; 154(5): 667. CrossRef

Relationship between Corrected QT Interval and Cardiovascular Risk Factors in Young Healthy Adults: The Kangwha Study.: Song Vogue Ahn, Hyeon Chang Kim, Nam Wook Hur, Kyoung Soo Ha, Hoo Sun Jang, Jin Bae Kim, Il Suh; J Prev Med Public Health. 2006;39(6):455-461.

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Prolongation of the heart rate-corrected QT (QTc) interval has been reported to be associated with cardiovascular morbidity and mortality. However, few studies have examined the relationship between the QTc interval and cardiovascular risk factors in young healthy people. The aim of this study was to examine the associations between the QTc interval and cardiovascular risk factors in young healthy adults. METHODS: This study was performed as part of the Kangwha study, which started in 1986, and is an on-going follow-up study on blood pressure and related cardiovascular risk factors. In follow-up examinations during 2005, cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry and carotid ultrasonography, were measured, and questionnaires on health behaviors completed by 127 men and 149 women aged 25 years. The QTc interval was measured on the resting 12-lead electrocardiogram using an automatic analysis program. RESULTS: The mean QTc interval was significantly longer in women (419+/-17ms) than in men (405+/-17ms) (p<0.001). A significant positive correlation was found between the QTc interval and waist-hip ratio (p=0.030) in men. Women showed a positive correlation between the QTc interval and systolic blood pressure (p=0.017). On a multiple regression analysis, the QTc interval was positively associated with the waist-hip ratio in men (p=0.012) and with the systolic blood pressure (p=0.020) in women. CONCLUSIONS: In young healthy Korean adults, the QTc interval was independently associated with the waist-hip ratio in men and with the systolic blood pressure in women.; Summary

Dipstick Urine Protein, as a Predictor of Cardiovascular Mortality in Korean Men: Korea Medical Insurance Corporation Study.: Kyoungsoo Ha, Hyeon Chang Kim, Dae Ryong Kang, Chung Mo Nam, Song Vogue Ahn, Il Suh; J Prev Med Public Health. 2006;39(5):427-432.

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This study was to investigate if the dipstick proteinuria can predict cardiovascular mortality in a population of Korean men. METHODS: We measured urine protein and other cardiovascular risk factors in 100059 Korean men, aged between 35-59 years in 1990 and 1992. Levels of proteinuria measured by dipstick method were trace or less, 1+, 2+, and 3+ or greater. The primary outcomes were deaths from all causes, cardiovascular disease, cancer, and others in a 12 year follow-up from 1993 to 2004. RESULTS: The multivariate-adjusted relative risks (95% CI) for cardiovascular death according to the level of proteinuria (1+, 2+, 3+ and more) in 1990 examination were 2.18 (1.36-3.48), 2.55 (1.37-4.78), and 4.57 (2.16-9.66) respectively. The corresponding relative risks according to the level of proteinuria in 1992 examination were 2.49 (1.71-3.64), 2.64 (1.53-4.58), and 2.78 (1.15-6.73). The relative risks for cardiovascular death of men with proteinuria (1+ or greater) once and twice among the examinations were 2.18 (1.63-2.92) and 3.75 (2.27-6.18), compared with men without proteinuria in 1990 and 1992 examinations. CONCLUSIONS: Our results showed that dipstick proteinuria is associated with cardiovascular mortality in Korean men. Dipstick proteinuria could be a predictor for cardiovascular mortality.; Summary

Kangwha Study Association Analysis of the Essential Hypertension Susceptibility Genes in Adolescents: Kangwha Study.: Il Suh, Chung Mo Nam, Sung Joo Kim, Dong Jik Shin, Nam Wook Hur, Dae Ryong Kang; J Prev Med Public Health. 2006;39(2):177-183.

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Abstract PDF: OBJECTIVES
In this study we examined the association between the genetic markers ACE (A-240T, C-93T, I/D, A2350G), AGT (M235T), AT1R (A1166C), CYP11B2 (T-344C, V386A), REN (G2646A), ADRB2 (G46A, C79G, T-47C, T164I), GNB3 (C825T) and ADD1 (G460W) and the presence of essential hypertension in adolescents. METHODS: The Kangwha Study is an 18-year prospective study that is aimed at elucidating the determinants of the blood pressure level from childhood to early adulthood. For this study, we constructed a case-control dataset of size of 277 and 40 family trios data from the Kangwha Study. For this purpose, we perform a single locus-based case-control association study and a single locus-based TDT (transmission/disequilibrium test) study. RESULTS: In the case-control study, the single locus-based association study indicated that the ADD1 (G460W) (p=0.0403), AGT (M235T) (p=0.0002), and REN (G2646A) (p=0.0101) markers were significantly associated with the risk of hypertension. These results were not confirmed on the TDT study. This study showed that genetic polymorphisms of the ADD1, AGT and REN genes might be related to the hypertension in Korean adolescents. CONCLUSIONS: This study provided useful information on genetics markers related to blood pressure. Further study will be needed to confirm the effect of the alpha adducin gene, the angiotensinogen gene and the renin gene on essential hypertension.; Summary

Statistical Algorithm in Genetic Linkage Based on Haplotypes.: Jinheum Kim, Dae Ryong Kang, Yun Kyung Lee, Sun Mi Shin, Il Suh, Chung Mo Nam; J Prev Med Public Health. 2004;37(4):366-372. Published online November 30, 2004

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Abstract PDF: OBJECTIVES
This study was conducted to propose a new transmission/disequilibrium test (TDT) to test the linkage between genetic markers and diseasesusceptibility genes based on haplotypes. Simulation studies were performed to compare the proposed method with that of Zhao et al. in terms of type I error probability and powers. METHODS: We estimated the haplotype frequencies using the expectation-maximization (EM) algorithm with parents' genotypes taken from a trio dataset, and then constructed a two-way contingency table containing estimated frequencies to all possible pairs of parents' haplotypes. We proposed a score test based on differences between column marginals and their corresponding row marginals. The test also involved a covariance structure of marginal differences and their variances. In simulation, we considered a coalescent model with three genetic markers of biallele to investigate the performance of the proposed test under six different configurations. RESULTS: The haplotype-based TDT statistics, our test and Zhao et al.'s test satisfied a type I error probability, but the TDT test based on single locus showed a conservative trend. As expected, the tests based on haplotypes also had better powers than those based on single locus. Our test and that of Zhao et al. were comparable in powers. CONCLUSION: We proposed a TDT statistic based on haplotypes and showed through simulations that our test was more powerful than the single locus-based test. We will extend our method to multiplex data with affected and/or unaffected sibling (s) or simplex data having only one parent's genotype.; Summary

Factors Associated with Hypertension Control and Antihypertensive Medication among Hypertensive Patients in a Community.: Dong Han Lee, Youn Hee Choi, Kang Hee Lee, Dae Ryong Kang, Sun Ha Jee, Chung Mo Nam, Il Suh; Korean J Prev Med. 2003;36(3):289-297.

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Abstract PDF: OBJECTIVES
The main objectives of this study are to identify the factors associated with hypertension control and to determine the influencing factors associated with antihypertensive therapy. METHODS: The study was conducted on 107 subjects who participated in the 1999 and 2002 Gwacheon Study and who had had uncontrolled hypertension (systolic > or=140 or diastolic > or= 90mmHg) in 1999. We compared the characteristics of the controlled and uncontrolled hypertensive group and investigated the characteristics of those taking antihypertensive medication. Univariate associations between hypertension control and its characteristics and the association between antihypertension treatment and its characteristics were tested with x2-test. We also performed logistic regression analysis. RESULTS: The participants who had their blood pressure checked within 6 months before their first measurement and those who had taken the antihypertensive medication showed significantly better hypertension control during the follow-up. The multivariate analysis showed that baseline antihypertensive therapy was the most important determinant factor of hypertension control during the follow-up. Socioeconomic level and life style did not affect hypertension control when controlled by the treatment variable in this study. The factors associated with antihypertensive therapy at follow-up were previous antihypertensive therapy, old age, and high educational level. CONCLUSIONS: Those who received antihypertensive therapy and those who had their blood pressure re-checked within 6 months both showed well controlled hypertension. The subjects with high educational level complied well with the antihypertensive regimen, but those in their forties did not.; Summary

Awareness, Treatment, Control, and Related Factors of Hypertension in Gwacheon.: Youn Hee Choi, Chung Mo Nam, Mi Hyun Joo, Ki Tae Moon, Jee Seon Shim, Hyeon Chang Kim, Il Suh; Korean J Prev Med. 2003;36(3):263-270.

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Abstract PDF: OBJECTIVES
To identify the factors related to awareness, treatment, and control of hypertension in a Gwacheon population. METHODS: This study surveyed 1, 176 Gwacheon residents older than 40 years, and measured blood pressure using a standardized guideline in 1999. The study subjects were 473 adults (175 males, 298 females) with hypertension defined as a systolic blood pressure > or= 140 mmHg, diastolic blood pressure > or= 90 mmHg or reported treatment with antihypertensive medications. Information on awareness, treatment, and control of hypertension, and sociodemographic and health-related factors was collected through person-to-person interviews with a structured questionnaire. RESULTS: Overall, 252 (53.3%) of hypertensive subjects were aware of their condition, of whom as many as 193 (76.6%) were being treated, and 81 (42.0%) had their blood pressure controlled at the recommended level (< 140/90 mmHg). However, of the 473 subjects found to have hypertension, only 40.8% were being treated, and 17.1% were under control. There were no significant differences in the proportions of awareness, treatment, and control of hypertension. In multiple logistic regression models, awareness of hypertension was positively associated with age and family history of hypertension in females. Control of hypertension was also positively associated with having a partner and marital status in females. CONCLUSION: These findings demonstrate that much greater efforts on improving awareness, treatment, and control of hypertension are needed, even in urban community settings, considering related factors such as age, family history, and marital status. However, these factors should be further investigated for their causal relationship.; Summary

Risk Factors for Cerebrovascular Disorders in Koreans.: Jong Ku Park, Ki Soon Kim, Chun Bae Kim, Tae Yong Lee, Duk Hee Lee, Kwang Wook Koh, Kang Sook Lee, Sun Ha Jee, Il Suh, So Yeon Ryu, Kee Ho Park; Korean J Prev Med. 2001;34(2):157-165.

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Abstract PDF: OBJECTIVES
To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. METHODS: The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (I60-I68) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. RESULTS: In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. CONCLUSION: We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.; Summary

A Nested Case Control Study on Risk Factors for Coronary Heart Disease in Korean.: Ki Soon Kim, So Yeon Ryu, Jong Park, Jong Ku Park, Chun Bae Kim, Byung Yeol Chun, Tae Yong Lee, Kang Sook Lee, Duk Hee Lee, Kwang Wook Koh, Sun Ha Jee, Il Suh; Korean J Prev Med. 2001;34(2):149-156.

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Abstract PDF: OBJECTIVE
To elucidate risk factors for coronary heart diseases among Korean males. METHODS: A nested case control study was conducted among a Korea Medical Insurance Cooperation(KMIC) cohort composed of 108,802 males. The cases included 246 male patients who were admitted to hospital due to coronary heart diseases from 1993 to 1997 (I20-25 by ICD) and whose diagnosis was confirmed by the protocol by WHO MONICA Project(1994). The control group was composed of 483 patients selected by frequency matching considering age and resident area from an inpatient care group without coronary heart disease during the same period. For study cases and the controls, the results of a health check-up in 1990 and a questionnaire on life style in 1992 were received through the KMIC. Some additional information was collected by telephone interviews during October 1999. RESULTS: Multiple logistic regression analysis showed that the odds ratio(OR) of coronary heart diseases among past smokers and current smokers as compared to non-smokers were 1.94(95% CI : 1.14-3.31) and 2.20(95% CI : 1.35-3.59), respectively. The OR among persons who drank 4 cups or more of caffeinated beverages such as coffee or tea daily as compared to persons who drank one cup for 2-3 days was 2.56(95% CI : 1.07-6.12). The OR among persons with high normal BP and stage 3 hypertension against normotension were 2.51(95% CI : 1.44-4.37) and 5.08(95% CI : 2.38-10.84). The OR among persons whose blood cholesterol were 240 mg/dL or more against lower than 200mg/dL was 2.24(95% CI : 1.43-3.49). CONCLUSION: Smoking, drinking of excessive caffeinated beverages, hypertension and high blood cholesterol were proven to be significant risk factors for coronary heart diseases among Korean males.; Summary

Timing of Menarche and Physical Growth during Childhood and Adolescence: The Kangwha Study.: Chang Soo Kim, Chung Mo Nam, Duck Hi Kim, Hyun Chang Kim, Kang Hee Lee, Sun Ha Jee, Il Suh; Korean J Prev Med. 2000;33(4):521-529.

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Abstract PDF: OBJECTIVES
To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.; Summary

Factors Related to Self-Perceived Health of Young Adults.: Kee Ho Park, Woohyun Cho, Il Suh, Jong Ku Park; Korean J Prev Med. 2000;33(4):415-425.

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Abstract PDF: OBJECTIVES
To determine which factors are related to young adults perception of their health. Two research questions were asked. Which aspects of health does self-perceived health as a index of general health reflect? Why do two individuals with the same level of general health have different health perceptions? METHODS: The sampling frame comprised college or graduate school students, aged 20 to 29, who were members of A, one of the 4 biggest internet communication services. The questionnaires were sent to study samples(n= 1,000) and answered by E-mail. Response rate was 37.0%. RESULTS: Firstly, physical health ranked highest and self-perceived health ranked lowest. Secondly, health, anxiety, depression, and self-perceived health showed significant differences between the sexes, with women showing a higher health status in these categories except for self-perceived health. Thirdly, the two factors significantly related to self-perceived health were physical health and self-esteem, as determined by multivariate analysis. CONCLUSIONS: The factors significantly related to self-perceived health were physical health and self-esteem. Further studies of the health characteristics of young adults are needed.; Summary

Factors Affecting the Participation Rate in the Health Screening Program of Medical Insurance.: Sung Tae Youn, Han Joong Kim, Sun Ha Jee, Il Suh, Heechoul Ohrr; Korean J Prev Med. 2000;33(2):150-156.

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Abstract PDF: OBJECTIVE
To analyze the factors affecting the participation rate in the health screening program of medical insurance. METHOD: We investigated the factors associated with the participation rate in the health screening program in Korea. Data were collected at the aggregate level from 145 employee health insurance societies and 227 self-employed health insurance societies from 1995 to 1997. Data were also collected at the individual level from four health insurance societies. This study hypothesized that the participation rate of the health screening program was related to 1) the characteristics of its members and the size of the health insurance society; 2) the specifications of the health screening program; 3) the venue of the health screening institution and the interests of individuals in the health screening program; and 4) the activities of the health insurance society. We used bivariate and multiple regression models to examine the factors on the participation rate of the health screening program. RESULTS: First, in the case of dependents of on employee health insurance society, the ratio of dependents 40 years old and over, the average monthly contribution per household, the interest and satisfaction level of individuals in health screening, and the level of refunds for over-payment were all associated with the participation rate in the health screening program, accounting for 54.4% of the participation rate. Second, in case of those insured by the self-employed health insurance society, the interest and satisfaction level of individuals in health screening, the level of refunds for over-payment, and the performance level of on-the-spot health screening were statistically significant, accounting for 40.1% of the participation rate. CONCLUSION: The factors concerning the participation rate in the health screening program of medical insurance, in both a health insurance society and for individuals, were closely related to the age and gender of individuals and household contributions.; Summary

The Accuracy of ICD codes for Cerebrovascular Diseases in Medical Insurance Claims.: Jong Ku Park, Ki Soon Kim, Chun Bae Kim, Tae Yong Lee, Kang Sook Lee, Duk Hee Lee, Sunhee Lee, Sun Ha Jee, Il Suh, Kwang Wook Koh, So Yeon Ryu, Kee Ho Park, Woonje Park, Seungjun Wang, Hwasoon Lee, Yoomi Chae, Hyensook Hong, Jin Sook Suh; Korean J Prev Med. 2000;33(1):76-82.

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Abstract PDF: OBJECTIVES
We attempted to assess the accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. METHODS: A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met one of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. RESULTS: The accuracy rate of the ICMIC was 83.0% (425 cases). Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. CONCLUSION: The accuracy rate of the ICMIC was 83.0%.; Summary

Twelve-year Incidence of Hypertension and Its Risk Factors in a Lean Population: the Kangwha Study.: Hyeon Chang Kim, Il Suh, Kang Hee Lee, Sun Ha Jee, Chang Soo Kim, Chung Mo Nam; Korean J Prev Med. 1999;32(4):435-442.

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Abstract PDF: OBJECTIVES
The purpose of this study was to examine the twelve-year incidence of hypertension, and to find risk factors for the incidence in adult population in Kangwha County, Korea. METHODS: In 1986, 413 males(mean age 37 years) and 434 females(mean age 33 years) were examined in the Kangwha Study. Among 764 non-hypertensive participants, 164 males and 214 females were reexamined in 1998. Blood pressure(BP) was measured with standard mercury sphygmomanometers. Multiple logistic regression analysis was used to estimate the relative risk of risk factors on the incidence of hypertension. RESULTS: During the 12-year period, 68 of 164 males and 53 of 214 females developed hypertension. In a multiple logistic model adjusted for age and pulse rate, baseline BP, baseline body mass index(BMI) and BMI change during the follow-up period were significantly related to the incidence of hypertension. Adjusted relative risk(RR)s of baseline high-normal BP were 3.90(95% CI: 1.81-7.84) in males, and 12.72(95% CI: 3.70-30.73) in females. Compared with lower baseline BMI group, adjusted RRs of middle baseline BMI group were 2.66(95% CI: 1.19-5.70) in males, and 2.33(95% CI: 0.95-5.55) in females. Adjusted RRs of upper baseline BMI group were 3.52(95% CI: 1.53-7.67)in males and 3.63(95% CI: 1.50-8.43) in females. Increase of BMI was positively related to the incidence in males(adjusted RR=2.71, 95% CI: 1.00-6.71) and females(adjusted RR=3.05, 95% CI: 1.29-6.88). CONCLUSIONS: The twelve-year incidence of hypertension was 41.5% in males, and 25.8% in females. Baseline BP, baseline BMI, and BMI change were strongly related to the incidence of hypertension.; Summary

The effect of sodium and potassium intake on blood pressure change in Korean adolescents.: Il Suh, Chung Mo Nam, Kang Hee Lee, Sun Ha Jee, Suk Il Kim, Gyu Sang Kim, Chun Bae Kim; Korean J Prev Med. 1998;31(3):384-394.

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Abstract PDF: In order to investigate the effect of the urinary excretion of sodium and potassium on the change on blood pressure over 3 years, 668 adolescents aged 13 years living in Kangwha area were investigated in a longitudinal follow-up study. Two measurements were taken on each blood pressure (diastolic, systolic) and the average of the two readings was used in the analysis. Sodium and potassium intake were estimated by the determination of those electrolytes in 24hr urine. The mixed model regression analysis was used to identify the effect of urinary sodium and potassium on the change of blood pressure after controlling for BMI of each age. On simple bivariate analysis no relationship was found between urinary sodium excretion and systolic or diastolic blood pressure among both male and female, however, a significant positive association between urinary potassium excretion and systolic blood pressure among male. The results of mixed regression analysis showed that the body mass index (BMI) were more influential that urinary electrolytes among this study subjects. It suggested that risk factors observed from the adults, may not be identical with that of the growing aged population. After control of the BMI and age, significant association between sodium and diastolic BP among male, and association between potassium and systolic BP among female, were found. In summary, the results indicate that growth has been more influential than dietary factor on blood pressure for growing aged population.; Summary

Association of osteoarthritis and bone mineral density in women: The health and nutritional examination survey in Kuri.: Seung Soo Sheen, Soon Young Lee, Byung Hyun Min, Il Suh; Korean J Prev Med. 1997;30(4):669-685.

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Abstract PDF: Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examine the hypothessis that "bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea", subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10, 1997, the survey was conducted. Among the total number of selected sample population(1,656 people), response rate was 52.4 percent(348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analysis results are as follows. 1. General characteristics : Mean BMD was 0.493 g/cm2, mean age was 43.0, mean BMI was 23.9 kg/m(3). The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results : Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4296 vs. 0.5057 g/cm2). But, there were to few cases of osteoarthritis of hip and hand, so comparative studies of BMD in ostearthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance wer significantly related with BMD. 3. Multivariate analysis results : To examine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. Further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.; Summary

Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents.: Il Suh, Chung Mo Nam, Sun Ha Jee, Suk Il Kim, Young Ok Kim, Sung Soon Kim, Won Heum Shim, Chun Bae Kim, Kang Hee Lee, Jong Won Ha, Hyung Gon Kang, Kyung Won Oh; Korean J Prev Med. 1997;30(2):308-326.

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Abstract PDF: Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. a A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic diastolic BP at age 12 and 16 years old were 108.7 mmHg & 118.1 mmHg(systolic), and 69.5 mmHg & 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg & 113.5 mmHg(systolic) and 75.2 mmHg & 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index etc) increased consitantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend for females. Total fat intake increased at age 16 years compared with that at age 14 years. Composition of carbohydrate, protein and fat among total energy intake was 65:15:20 at age 14 and 16 years. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness, showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.; Summary

The Incidence of Hepatitis B in Military Service ad the Effect of Asymptomatic HBsAg Carriers on the Incidence.: Rock Kwon Kim, Il Suh, Hung Mo Nam, Kwang Hyub Han; Korean J Prev Med. 1997;30(2):267-278.

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Abstract PDF: The purpose of this study was to investigate the incidence rate of hepatitis B in the military service and to examine the effect of the asymptomatic HBsAg carriers on the incidence of hepatitis B. The subject were 223,270 men who were conscripted to the Korean Army from 1991 to 1994 year. According to the conscripted year, four conscription cohort were constructed. At the screening examination for military service no test for hepatitis B were performed in 1991 and 1992. In 1993, a screening test for hepatitis B were performed and those who were confirmed as HBsAg positive or > or = SGPT 100IU were excluded from conscription. In 1994, the criteria for conscription was changed and those who were HBsAg positive were not excluded from conscription. Only those who were > or =SGPT 100IU were excluded. The main results were as follows ; 1. The positive rate of HBsAg is 5.5% in the conscripted men. 2. The incidence rates of the hepatitis B in 1991 and 1992 conscription cohort were 9.96 and 8.10 per ten thousand per son - year, respectively. The incidence rate of the hepatitis B was 1.34 per ten thousand per son - year in 1993 conscription cohort which was confirmed as HBsAg negative at the screening test, and 7.41 per ten thousand per son - year in 1994 conscription cohort which included the HBsAg positive. 3. The incidence rate of hepatitis B was 99.98 per ten thousand per son- year in HBsAg positive group and 2.25 per ten thousand per son - year in HBsAg negative group. The incidence rate of the group with high SGPT and HBsAg positive was 255 times higher than that of normal population. 4. The incidence of hepatitis B in HBsAg negative group did not increase even though the probability of personal contact with HBsAg positive had been increased. From the above result s, the men who have high SGPT with HBsAg positive should be excluded from military service, and it can not be said that asymptomatic HBsAg carrier s influence on the hepatitis B incidence among the HBsAg negative through personal contact.; Summary

Four-year change and tracking of serum lipids in Korean adolescents.: Kang Hee Lee, Il Suh, Sun Ha Jee, Chung Mo Nam, Sung Soon Kim, Won Heum Shim, Jong Won Ha, Suk Il Kim, Hyung Gon Kang; Korean J Prev Med. 1997;30(1):45-60.

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Abstract PDF: It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes and girls. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probability of remaining at the same group was more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in he future to investigate the long-term change of lipids from adolescents to adults.; Summary

Twelve-year Study on Body Mass Index Changes of Obese Adolescents.: Yun Ju Kang, Il Suh, Chang Ho Hong, Jong Ku Park; Korean J Prev Med. 1994;27(4):665-676.

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Abstract PDF: The purpose of this study is to observe the longitudinal changes in BMI (Body Mass Index) of obese and non-obese 3rd. grade high school students in Seoul for 12 years and to see the trends of overt weight gain in obese adolescents. The results are as follows; 1. The average annual increasing rates of body mass indices in male students were 1.14kg/m2 in obese group and 0.59 in non-obese group. In female students, the average annual increasing rates of body mass indices were 0.93kg/m2 in obese group and 0.53kg/m2 in non-obese group. 2. The change rate of BMI for 12 years was significantly higher in obese group than non-obese group. 3. Puberty had less influence on the change rate of BMI in obese group compared to non-obese group. 4. In obese group, 71.8% of the variance in BMI at 17 can be predicted by BMI at 16 years in male students. In female students 44.4% can be predicted by BMI at age 16. 5. Among the 17-year-old obese students, 58.8% of the males and 56.2% of females were found not to have been obese at 7 years of age. 6. Among the 17-year-old obese students, those who were obese at 7 years of age were found to have higher BMI at later ages than those who were in the non-obese group. Obese adolescents were more likely to be obese in their childhood than non-obese group. There was no optimal age for the significant weight gain and the increasing rate of BMI was constantly higher in obese group than in non-obese group. Due to the fact that child obesity in early age contributes to obesity in adolescence, close observation is advised on the other hand, a large proportion of obese adolescents can be preventable by early interventions, because about 50% of obese adolescents were not obese in early elementary school age.; Summary

The Change In Blood Pressure And Factors Affecting The Change In Blood Pressure For Korean Children: A Six-Year Follow-Up Study.: Il Suh, Soon Young Lee, Chung Mo Nam, Il Soon Kim; Korean J Prev Med. 1993;26(1):96-109.

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Abstract PDF: For the purposes of analyzing the distribution and the change in blood pressure according to age and determining the factors affecting the change in blood pressure, a follow-up study had been conducted for 6 years from 1986 to 1991 for 430 primary school children age 6 years old in 1986 in Kangwha County, Korea. The mean blood pressure increased according to age. Specifically mean systolic blood pressure increased from 97.3 mmHg for male and 96.4mmHg for female(at 6 years of age) to 108.8mmHg for male and 112.1mmHg for female(at 11 years of age). Mean diastolic blood pressure increased from 60.0mmHg for male and 61.8mmHg for female(at 6 years of age) to 72.9mmHg for male 73.8mmHg for female(at 11 years of age). The average annual increase in blood pressure was 2.3mmHg(in systolic blood pressure) and 2.4mmHg(in diastolic blood pressure) for female, respectively. To determine the factors affecting the change in blood pressure, the stepwise regression analysis was conducted. Children were divided into the three groups(low, middle, and upper) according to the level of systolic and diastolic blood pressure at the age of 6, and the regression analysis was performed in each group. For the change in systolic blood pressure, the changes in weight and skinfold thickness or initial skinfold thickness for male, and the change in weight for female were selected as significant factors for children in middle and upper group. For the change of blood pressure in diastolic blood pressure, no variables was significant.; Summary

The Change of Children's Blood Pressure and Factors Affecting the Level of Blood Pressure In Children.: Il Suh, Il Soon Kim, Chung Mo Nam, Soon Young Lee, Hee Chul Oh, Chun Bae Kim, Eun Cheol Park; Korean J Prev Med. 1989;22(3):303-312.

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Abstract PDF: To show the distribution and change of blood pressure according to age and find factors affecting the level of blood pressure in primary school children, a follow-up study was conducted from 1986 to 1989 on 401 first grade children attending primary school in Kangwha county in 1986 and their parents. The blood pressure of the children was significantly increased according to age. The average annual increase was 1.8mmHg in systolic blood pressure and 2.5mmHg in diastolic blood pressure. The level of blood pressure did not show any significant difference in both sexes. Among children who were at or above the 80th percentile of blood pressure in the first grade, 35 and 30% of them have remained at the same level of systolic and diastolic blood pressure respectively in the fourth grade. But we could not find any significance in the tracking of blood pressure of children who were at or above the 90th percentile of blood pressure in the first grade. Weight and pulse rate were shown to significant factors affecting systolic blood pressure in children of both sexes and mother's blood pressure and skinfolds thickness were also affected systolic blood pressure in girls. The variables significantly affecting diastolic blood pressure were arm circumference and pulse rate for boys and height and pulse rate for girls.; Summary

Changes in Hospital and Clinic Care Patterns Under the Medical Insurance System.: Il Suh; Korean J Prev Med. 1981;14(1):3-12.

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Abstract PDF: To identify the changes in profession care patterns after the introduction of medical insurance in korea, professional care in hospitals and clinics of two succeeding years were compared. The hospital and clinics selected for this study were those which located in Seoul city. Hospital were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtain form the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studies were 3 months of each year form March 1st to May 3st in 1979 and 1980. The total number of normal deliverly studied was 289 in 1979, 301 in 1980 respectively and acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both disease in all types of hospital, but in the private clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities. More cost changes by items were seen in acute appendicitis than in normal deliverly between two study periods. The total hospital costs can be divided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospital was mainly due to the increase in the costs for drug for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal deliverly was characteristically increased in 1980 in all hospitals studied. In general in the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mention changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.L.C. for the assessment of the fee request made by clinics and hospitals.; Summary

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