- Determining Factors of Intention to Actual Use of Charged Long-term Care Services for the Aged.
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Jin Yeong Yoo, Jin Ho Chun
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J Prev Med Public Health. 2005;38(1):16-24.
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To help develop strategies to cope with the changes arising from the rapid aging process by predicting the determining factors of intention to actual use of the charged long-term care services for elderly as perceived by the middle aged who play the major role of supports. METHODS: Subjects were the parents (men 177, women 507) in their 40s of the students selected from a university of Busan city. A questionnaire survey was conducted for 4 weeks in October 2003 about the knowledge for long-term care service, the intention of actual use, and the preferences about the type of service suppliers. Data analysis was performed with frequency, chi-square test, and t-test using SPSS program (ver 10.0K), along with data mining using decision tree of Enterprise Miner V8.2 by SAS. RESULTS: About half of the subjects (53.7%) had the actual experiences of elderly supports. Intentions to use the charged services were relatively high in home visiting nursing care service (40.1%) and long-term care facilities service (40.4%), and were influenced by previous knowledge about the services. The intentions were stronger in women, those with higher education, and those with greater income levels. Actual elderly supports were mostly (80%) done by women, and the perceived burdens for the supports were bigger in women and those of lower socio-economic level. Desired charges were about 10, 000 won for the bath service, 20, 000 won for the rests services per day, and about 500, 000 won for the long-term care facilities service per month. From the result of decision tree analysis, the job professionalism was the most important determining factor of intention to actual use of the services with validation as 63~71%. Health and welfare mixed type facilities were preferred, and the most important consideration was the level of professionalism. CONCLUSIONS: Intention to actual use of the charged services was largely determined by the aspects of time and cost. Polices to increase the number of service suppliers and to decrease the burdens perceived by actual supporters were strongly recommended.
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- Effects of Chromium (VI) Exposure on the Placental Function and Reproduction in Rats.
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Heun Lee, Jin Ho Chun, Deog Hwan Moon, Chae Un Lee, Sung Goo Kang, Byung Chul Son, Dae Hwan Kim, Chang Hee Lee, Jung Won Kim, Chae Kwan Lee
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J Prev Med Public Health. 2004;37(2):157-165.
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- OBJECTIONS: This study aimed to investigate the toxic effects of chromium (VI) on the placental function and reproduction in rats. For the study, the placental prolactin-growth hormone (PRL-GH) gene expression, placental trophoblast cell differentiation and reproductive data were analyzed. METHODS: The pregnancies of F344 Fisher rats were checked by the presence of a copulatory plug or sperm in the vaginal smear, which was defined as day 0 of the pregnancy. Pregnant rats were divided into the three groups. The control group was given tap water (chromium level < 0.001 ppm) and the remaining groups were given 250 or 750 ppm of chromium (VI) [as potassium dichromate], from day 7 to 19 of the pregnancy. Rats were sacrificed at days 11 and 20 of pregnancy. The mRNA levels of PRL-GH and Pit-1a and b isotype genes were analyzed by Northern blot hybridization and reverse transcriptionpolymerase chain reaction (RT-PCR). The hormonal concentration was analyzed by radioimmunoassay, and the differentiation of placental trophoblast cells were observed by histochemical studies. Reproductive data, such as placental and fetal weights, pregnancy period, and litter size, were surveyed at day 20 of pregnancy and after birth. A statistical analysis was carried out using the SAS program (version 8.1). RESULTS: The mRNA levels of the prolactin-growth hormone (PRL-GH) family of genes were dose dependently reduced by chromium exposure. The mRNA levels of Pit-1a and b isotype genes that induce the expression of the PRL-GH family of genes were also reduced by chromium exposure. The PRL-GH hormonal concentration in the rat placenta, fetus and maternal blood were decreased by chromium exposure. In the middle stage of pregnancy (day 11), a high dose of chromium suppressed the differentiation of spongiotrophoblast cells that secret the PRLGH hormones. In the last stage of pregnancy (day 20), a high dose of chromium induced apoptosis of placental cells. Reproductive data, such as placental and fetal weights, litter size, were reduced, but the pregnancy period was extended in the group exposed to chromium compared with the controls. CONCLUSION: Chromium (VI) disrupts the ordered functions of the placenta, which leads to reproductive disorders in rats.
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Summary
- Evaluation of Field Epidemiology Specialist Training Program Based on the Satisfaction and the Changes of Educational Needs.
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No Rai Park, Ihn Sook Jeong, Jong Gu Lee, Young Taek Kim, Jin Ho Chun, Ki Soon Kim, Sang Soo Bae, Jong Myon Bae, Gyung Jae Oh, Hee Chul Ohrr, Kun Sei Lee, Byung Kook Lee, Hun Jae Lee, Hyun Sul Lim, Young Hwangbo
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J Prev Med Public Health. 2004;37(1):80-87.
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To evaluate the learning achievement and satisfaction levels for the Field Epidemiology Specialist Training Program (FESTP), on infectious disease control between March 19 and October 31, 2002. METHODS: The FESTP was designed as a set of 84 hours curricula including lectures, discussions, self-studies, and field practicals, and organized both centrally and locally by the Division of Communicable Disease Control of the National Institute of Health and 11 universities. Before and after the program, a questionnaire survey on the educational need (49 items) and satisfaction (15 items) was conducted on 484 trainees, who were responsible for communicable disease control and immunization at 242 regional health centers. The data were analyzed with paired t-tests for comparison of the educational needs between the pre and post scores. RESULTS: The average score for satisfaction was 3.06 out of 5.0; with relatively higher scores for sincerity (4.10) and professionalism (4.01) of the tutors, adequacy (3.54) and clearness (3.51) of the evaluation criteria, usefulness (3.54) and fitness (3.52) of the contents, but with relatively lower satisfaction for schedule (2.96) and self-studies (2.91). The average for requirement for education improved, as shown by the decrease from 2.72 to 2.22 (p< .0001) with the biggest decrease in the outbreak investigation from 2.60 to 2.08. CONCLUSION: The FESTP was evaluated as being effective, the trainees showed moderate satisfaction and decrease educational needs. However, the actual schedules and self-studies should be rearranged to improve the satisfaction level.
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Summary
- Prevalence Rate of Cognitive Impairment and Dementia Among the Elderly in Busan.
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Jung Soon Kim, Su Ill Lee, Ihn Sook Jeong, Young In Chung, In Kyung Hwang, Bong Sook Yih, Min Jeong Kim, Eu Soo Cho, Jin Ho Chun
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Korean J Prev Med. 2003;36(1):63-70.
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To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. METHODS: Total of 1, 101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. RESULTS: With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. CONCLUSIONS: The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.
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Summary
- A Trial for Development of Health Profile (KHP 1.0) to Measure the Self-Perceived Health Status of Korean.
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Jin Seon Yang, Jin Ho Chun
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Korean J Prev Med. 2003;36(1):11-23.
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The 1990s has seen advances in the conceptualization of self-perceived health status which has important roles for individual health and the quality of life. Many types of standardized questionnaires have been developed with the current wide use of SF-36, NHP, andEuroQol. However, the outcomes of these tools may be different with regard to regional, cultural and emotional backgrounds. The purpose of this study was to trial the development of a Korean Health Profile (KHP 1.0) to measure the self-perceived health stati of Koreans. METHODS: The KHP 1.0 was designed on the basis of the Medical Outcome Study Form 36 (SF-36), the Nottingham Health Profile (NHP), and the EuroQOL. It was composed of 9 scales; physical functioning, role limitation-physical, pain, general health, energy, social isolation, sleep, role limitation-emotional, and emotional health. Self-reported chronic disease conditions, and the Zung's Self-Rating Depression Scale (SDS), were also checked for the evaluation of clinical validity. This study was conducted, from December 2000 to January 2001, on 800 middle-aged parents, with four high school students, with 100 retest sets being conducted two weeks later. From the 800 subjects there were 588 complete responses (effective response 73.5%). The reliability of the test-retest results, and the factor analysis on the validity of the KHP 1.0 components, were evaluated using the SPSS (ver 10.0) software. RESULTS: The reliability of the KHP 1.0 was good with Cronbach's alpha (> 0.6), test-retest correlation coefficients (> 0.5), but with no significant differences from the paired t-test. From the psychometric validity tests, the 9 scales of the KHP 1.0 were divided into two components; physical and mental, and trimmed to the established model with 55% of the total variance, with the exception of role limitation-emotional. The clinical validity on the basis of the comparison for the four characteristic groups; healthy, physical conditions only, mental conditions only, and physical and mental conditions were also good. CONCLUSIONS: The KHP 1.0 appears to be a valid measurement tool of self-perceived health stati of Koreans, although there are limitations, i.e. sample size was too small, a limited number of middle-aged subjects, and it was based on unconfirmed diagnoses, etc. Therefore, further study is required to standardize the assessment.
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Summary
- A Review Study for Developing Health Profiles to Measure the Self-Perceived Health Stati of Koreans.
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Jin Ho Chun, Jin Sun Yang
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Korean J Prev Med. 2003;36(1):1-10.
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- Valid evaluation of self-perceived health status is important for the promotion of individual health and quality of life. In advanced countries, many types of health profile have been developed, and currently, the SF-36, NHP, and EuroQol, etc, are widely used. However, the outcomes of these profiles may vary according to regional, cultural or emotional backgrounds. For these reasons a Korean Health Profile should be developed. In this study, we reviewed the concept of self-perceived health status, and its significance to public health, and reviewed some of the differences between the available profiles in 139 related publications. Based on this review, we are trying to develop a Korean Health Profile in order to measure the self-perceived health stati of Koreans.
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Summary
- Factors Influencing the Intention of Admission into a Charged Nursing Home for the Elderly.
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Jin Ho Chun, Young Soon Yoo, Eun Hi Cho, Byung Chul Yu, Ki Won Jeong, Sang Hwa Urm, Sung Jun Kim
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Korean J Prev Med. 2001;34(1):1-8.
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To gather information about the factors which influence the interest and intention of admission into charging nursing homes for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. METHODS: A face-to-face interview survey was carried out with 328(men 159, women 169) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. microgram/g RESULTS: The mean age and years of education of the study population was 67.8 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children in the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission(3.07+/-1.39) into a CNH was lower than that of interest(3.22+/-1.33)(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons(beta=0.107), lower level of activity in daily life(beta=0.447), and longer years of education(beta=0.447) with 32.7% of R2. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred "elderly hospital" or "elderly health center" to CNH. CONCLUSIONS: Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, through CNH.
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Summary
- Analysis of Pap Smear Results over Twenty Year Period, 1979-1998.
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Ji Won Han, Jin Ho Chun, Dae Hoon Jeong, Ki Tae Kim, Hye Kyoung Yoon
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Korean J Prev Med. 2000;33(4):505-512.
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To estimate the significance of the Pap smear as a screening tool for cervical cancer. METHODS: A total of 79,840 Pap smear results performed at Pusan Paik Hospital over the 20 year period from 1979 to 1998 were collected and analyzed. RESULTS: The number of Pap smear cases increased markedly during this period, and the results as a whole were classified as consisting of 96.4% normal and benign cytology, 2.2% pre-cancerous cytology, and 1.4% cervical cancer. The relative frequency of cervical cancer decreased from 1.6% in 1979 to 0.7% in 1998. About 64% of the Pap smears were distributed within the age range of 30 to 49 years, and the rate of cervical cancer increased with age, age of marriage and experience of childbirth (p<0.01). The overall agreement of Pap smear results with histologic diagnosis by one histologic degree was 92.7%(1,128/1,217) with 73 overestimated cases and 16 underestimated cases of Pap smear compared to histologic diagnosis. CONCLUSION: This result implies that the Pap smear is an excellent screening tool for cervical cancer with respect to both its scale and validity. Periodic and active Pap smear testing would be helpful for the secondary prevention of cervical cancer.
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Summary
- Comparison of Methods for the Detection of Anti-HBs for Hepatitis B Vaccination Program in Korea.
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Hae Sook Sohn, Jeong Nyeo Lee, Sang Hwa Urm, Jong Tae Lee, Jin Ho Chun
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Korean J Prev Med. 2000;33(2):226-230.
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The purpose of this study was to suggest a proper method for the detection of heaptitis B surface antibody(anti-HBs) in a screening program for hepatitis B vaccination. METHODS: Sensivitity, specificity and predictive values were compared between Immunochromatographic assay (ICA) and passive hemagglutination(PHA) in 978 subjects(565 males, 413 females, 19-78 years ranging in age, mean 46.5 years old). EIA was used as a standard method for the detection of HBsAb. RESULTS: Sensitivity in the detection of anti-HBs of PHA and ICA was 88.7% and 94.9%, specificity was 94.3% and 96.6%, negative predictive value was 96.5% and 98.0%, and positive predictive value was 82.3% and 91.3%, respectively. False negative rate(11.3%) of PHA was higher than that(5.1%) of ICA. The higher the titer of anti-HBs in EIA was, the lower the false negative rate was. There was no false negative result in the cases with 101mIU/ml or more in EIA. CONCLUSION: We suggest that ICA should be the choice of screening method in the detection of anti-HBs in Hepatitis B vaccination program.
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- A Study on the Health Status of Korean Vietnam Veterans' Children: A Result of Questionnaire Survey on Vietnam Veterans of Pusan Area Who Diagnosed as Cases by Korean Veteran's Hospital Diagnostic Criteria.
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Jin Ho Chun, Hak Joon Kim, Hae Sook Sohn, Sang Hwa Urm, Soo Kyung Park, Byung Chul Yu, Jong Tae Lee
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Korean J Prev Med. 2000;33(1):17-24.
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To propose the referential data to evaluate the health impacts of Vietnam veterans' children whose father were exposed to herbicides in Vietnam War. METHODS: Vietnam veterans who visited to Pusan Veteran Hospital for medical care were recruited from April to October, 1998. They were 71 and asked about their own combat history, symptoms and illness, and health status of their 182 children. The informations were collected by direct and phone interview. Exposure estimation was also performed as exposure score depending on year and unit of participation, and personal episodes related to exposure to herbicide in the war. It classified into three groups; lower(<18.0), moderate(18-53), high(> or =53) exposure group. RESULTS: The mean age and the period into the combat of the veterans were 52.8 years and 15.0 months. The mean exposure score was 18.1+/-9.9, and mainly distributed in lower (46.5%) and moderate(52.1%) exposure group. Most(90.1%) of them were diagnosed as sequelae(21 cases) and suspected sequelae(43 cases) of the herbicides by Korean veteran's hospital diagnostic criteria. The major sequelae was peripheral neuropathy 13 cases, chloracne 5 cases, and the major suspected sequelae was hypertension 20 cases, diabetes mellitus 18 cases, liver disease 12 cases, central neuropathy 11 cases, etc. About birth, 42.2% and 16.9% experienced spontaneous abortion and stillbirth, respectively. The mean exposure score was higher in stillbirth experience group(p<0.05). About half of the children(90 cases, 49.5%) hold the abnormal health status: those were skin pigmentation 38 cases, rash 23 cases, congenital anomaly 15 cases, general weakness 12 cases, purpura 8 cases, visual disturbance 8 cases, etc. These health problems had no association with father's exposure level(p>0.05). CONCLUSIONS: These results were depend on their own answers, and expectation for compensation did not excluded, therefore, this study may have limitations: inaccuracy of informations due to recall bias and response bias. Nevertheless, through this study, we could image the fundamental aspect for health impacts of Vietnam veterans' children for preparing the national control program and policy. A large scale epidemiologic study with valid exposure assessment on the health impacts of Vietnam veterans' children is recommneded.
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Summary
- Relationship of Level of Stress, Life Style, Subjective Symptoms and Clinical Diagnosis in Clients taken Multiphasic Screening Program.
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Jun Han Park, Jin Ho Chun, Jang Mi Kang, Byung Chul Son, Dae Hwan Kim, Chang Hee Lee, Kui Won Jeong, Sang Hwa Urm
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Korean J Prev Med. 1998;31(4):728-739.
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- To improve wellness and quality of life by recognizing the health effects of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests - electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase(gamma-GTP), fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was 46.5+/-11.2 years and the mean of body mass index was 24.0+/-3.7kg/m2. The mean level of stress was 18.5+/-6.0 expressed as the score out of 40. By general characteristics and life style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skipping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lower socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system(p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom(gamma=0.476) and cardio-vascular symptom(gamma=0.361) in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom(gamma=0.371). The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life through, therefore, it would be of value that periodic stress evaluation program and stress management including appropriate control of smoking and drinking, regular exercise and meal.
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Summary
- Effect of Therapeutic Exercises on Shoulder Dysfunction in VDT-related female Office Workers.
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Soon Seok Choi, Kui Won Jeong, Sang Hwa Urm, Soo Jin Jeong, Jong Tae Lee, Jin Ho Chun, Chae Un Lee, Ki Taek Pae
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Korean J Prev Med. 1998;31(2):228-239.
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- Visual display terminal(VDT) is popular in majority of office in modern countries. Musculoskeletal pain due to repetitive work with VDT is a serious industrial accident at present. In recent studies, shoulder pain in VDT users is the most common problem in Korea. The purpose of this study was to evaluate and compare the effect of exercises on shoulder dysfunction in VDT-related female office workers. Of the l19 patients with shoulder dysfunction, 32 patients entered into the study. 16 patients(Group I) were not prescribed exercises, other 16 patients (Group II) performed throughout the specific shoulder exercises such as pendular exercises(forward, backward and circumduction) and sidelying external rotation exercises with weights. After 3 months of exercises, the two groups were compared in term of the pain rating scale, disability questionnaire score and range of motion score. The results were summarized as follows ; l. The pain rating scale in Group I before and after 3 months were not differenced significantly(p value=0.784) and in Group II, the scale before and after exercises were differenced significantly(p value=0.0005). 2. The disability, questionnaire scores in Group I before and after 3 months were not differenced significantly(p value=0.437) and in Group II, the scores before and after exercises were differenced significantly(p value=0.0002). 3. The ROM scores of the affected shoulder in Group I before and after 3 months were not differenced significantly(p value=0.876) and in Group II, the scores before and after exercises were differenced significantly(p value=0.0017). In conclusion, that the specific shoulder exercises on shoulder dysfunction in VDT-related female office workers are encouraged.
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Summary
- PCR and RFLP-based CYP2D6(B) and CYP2D6(T) Genotyping for Korean Lung Cancer Cases and Controls.
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Jin Ho Chun, Chang Hee Lee, Sang Hwa Urm, Byung Chul Son, Jun Han Park, Kui Oak Jung, Chang Hak Sohn, Hye Kyoung Yoon, Choon Hee Son, Hyung In Kim, Jin Seok Kim
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Korean J Prev Med. 1998;31(1):1-14.
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- The genetically determined CYP2D6 activity is considered to be associated with cancer susceptibility with inter-individual variation. Genetic polymorphism of CYP2D6(B) and CYP2D6(T) was determined by the two polymerase chain reaction(PCR) and BstN1 and EcoN1 restriction fragment length polymorphisms(RFLP) for 67 lung cancer cases and 95 healthy volunteer controls. The cases were composed of 26 squamous cell carcinoma, 14 small cell carcinoma, 10 adenocarcinoma, 3 large cell undifferentiated carcinoma, and 14 not histologically diagnosed. The results were gained from the 142 subjects (57 cases and 85 controls) who observed successfully in two PCR and BstN1/EcoN1 RFLP. Only one and no mutant allele of the CYP2D6(B) and CYP2D6(T) gene was detected, that is, the frequency of mutant allele was very low; 0.7%(1/142) and 0%(0/142), respectively. Detected mutant allele of the CYP2D6(B) was heterozygous type(WM). The odds ratios for lung cancer susceptibility with CYP2D6(B) and CYP2D6(T) genotype were not calculated. These results are similar to the previous understanding that the mutant allele is very rare in Orientals compared to Caucasians, therefore, it considered that CYP2D6(B) and CYP2D6(T) genotypes have maybe no association with lung cancer susceptibility in Koreans. This is the basic data of CYP2D6(B) and CYP2D6(T) genotypes for Koreans. It would be hepful for further study to determine lung cancer susceptibility of Koreans with the data about CYP1A1, CYP2E1, GSTM1 from future study.
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Summary
- Relationship between Life Style, the Level of Stress and Irritable Bowel Syndrome on 1498 Male White Collars.
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Jong Ryul Kim, Sang Hwa Urm, Jin Ho Chun, Soo Jin Jeong, Chang Hee Lee, Kui Won Jeong, Soon Seok Choi, Ki Taek Pee
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Korean J Prev Med. 1997;30(4):791-804.
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- Irritable bowel syndrome(IBS) is one of the common health problem that has been considered as stress-induced. This study was conducted to investigate the relationship between life style and the level of stress and IBS by structured questionnaire which included questions on life style, the self-esteemed gastrointestinal symptoms, and Psychosocial Well-being Index(PWI). Subjects were 1,498 male white collars who get the regular health check and participated in survey at Inje University Health Promotion Center from January to December, 1996. The overall prevalence of IBS was 37.5%(561 cases), and the level of stress by PWI score was higher in IBS group(41.8+/-14.2) than symptom-free group(34.6+/-12.6). As the result of comparison between the two groups, heavier smoking (adjusted OR=2.48, 95% CI 1.81-3.41), longer daily working time (adjusted OR=5.19, 95% CI 3.59-7.56), stimulatory food materials-mainly hot or salty (adjusted OR=1.87, 95% CI 1.44-2.45), higher body mass index (adjusted OR=1.80, 95% CI 1.27-2.57), and higher level of stress (adjusted OR=2.81, 95% CI 1.80-4.43) were estimated as risk factors of IBS. On the contrary, 6-8 hours sleeping per day (adjusted OR=0.38 95% CI 0.21-0.70), 3-4 times exercise per week (adjusted OR=0.57 95% CI 0.39-0.83), and tenure more than 20 years (adjusted OR=0.25 95% CI 0.16-0.35) were considered as protective factors to IBS. In summary, the assessment of the stress level might be placed in the first priority to control IBS, at least by some degree, which suggested that IBS could be controlled by avoiding such risk factors and by encouraging such protective factors.
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Summary
- Seroepidemiologic Study of Hepatitis B Virus(HBV) and Hepatitis C Virus(HCV) Infection among Koreans in Rural Area, Korea.
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Hai Rim Shin, Joon Youn Kim, Jue Bok Song, Byung Seong Suh, Jung Man Kim, Bu Ok Lee, Su Ryang Kim, Mu Guan Yang, Chae Un Lee, Jin Ho Chun, Keun Young Yoo, Yoon Ok Ahn
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Korean J Prev Med. 1997;30(1):17-30.
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- To estimate the prevalence of hepatitis B virus(HBV) and hepatitis C virus(HCV) infection and to determine associated risk factors, a population-based seroepidemiologic study was carried out. In 1993, a health examination survey of the population was carried out in rural area known to have a high incidence of liver cancer. The study population were those who volunteered to participate in a health survey over 10 years of age. Examinees were interviewed by specially trained staffs. Sera from 1,033 study subjects were tested for hepatitis B surface antigen (HBsAg) by reverse passive hemagglutinin (RPHA) estimation and for hepatitis C virus antibody (anti-HCV) by 2nd generation passive hemagglutinin (PHA) estimation, The age and sex standardized prevalence of HBsAg was 6.3% which was similar to national average, but that of anti-HCV was 5.1% which was 4 to 5 times higher than that of blood or other health examinees in Korea. In a multivariate analysis, transfusion history, surgical operative history, and acupuncture history were not associated with HBsAg positivity. In contrast, acupuncture history (adjusted odds ratio[OR]=2.2 : 95% Confidence interval[CI] 1.0-4.7) and surgical operative history(adjusted OR=2.0 : 95% CI 1.0-4.1) were associated with anti-HCV positivity. The present study suggest that there is an highly endemic area of HCV infection in Korea and probably this endemicity is associated with a parenteral source of HCV infection other than blood transfusion.
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Summary
- Urinary Metabolites and Neurobehavioral Test on Styrene Exposure Workers.
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Chang Hee Lee, Deog Hwan Moon, Hun Lee, Jun Han Park, Dae Hwan Kim, Jong Tae Lee, Jin Ho Chun, Hwi Dong Kim, Chae Un Lee
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Korean J Prev Med. 1996;29(4):863-876.
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- In order to prepare the fundamental data for the health promotion by assessing the exposure level of styrene, the author determined the concentration of mandelic acid and phenylglyoxylic acid in urine of 42 workers who were exposed to styrene by high performance liquid chromatography and surveyed 16 symptoms, by questionnaire and also tested neurobehavioral test(digit symbol, benton visual retention) in 2 FRP plants of Kyung Nam area from July to September, 1995. Control was sampled by age sex matching method. The concentration of styrene in air was determined by gas chromatography. The results were as follows; 1. Geometric mean concentration of styrene in air was 17.4ppm, geometric mean concentration of mandelic acid(MA) in urine were 404.3mg/g creatinine for exposure group, 46.4mg/g creatinine for control group, geometric mean concentration of phenylglyoxylic acid(PGA) in urine were 57.5mg/g creatinine for exposure group, 9.5mg/g creatinine for control group. Mean concentration of MA and PGA showed statistically significant difference between exposure group and control group(p<0.01). 2. Number of symptom were 2.9 for exposure group, 3.3 for control group, number of digit symbol were 24.1 for exposure group, 32.5 for control group, number of Benton visual retention test were 6.1 for exposure group, 6.0 for control group, respectively. As result of adjusting the education year, number of Benton visual retention test showed statistically significant difference between exposure group and control group(p<0.05). 3. Excellent correlation were observed between environmental styrene exposure and urinary MA(r=0.80), PGA(r=0.73), and MA+PGA(r=0.81).
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- An Epidemiologic Study on Death Caused by Cancer in Pusan.
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Hwi Dong Kim, Hye Won Koo, Moon Suk Kwak, Jong Ryul Kim, Byung Chul Son, Deog Hwan Moon, Jong Tae Lee, Kyu Il Lee, Sang Hwa Ohm, Kui Oak Jung, Jin Ho Chun, Chae Un Lee
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Korean J Prev Med. 1996;29(4):765-784.
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- This study surveyed and measured the level and structure of cancer deaths and their trends over time for offering the fundamental data of the cancer prevention and control in Pusan city in the future. Authors conducted the study of descriptive epidemiology using materials derived from the computerized data of total 3,722 certified cancer deaths in Pusan city from January 1 to December 31, 1993 registered on the National Statistical Office, the Republic of Korea. The obtained results were as follows: 1. According to the total registered cases of deaths(16,331 cases) in Pusan city during 1993, cancer(3,722 cases) and cerebrovascular disease(2,718 cases) were the first and second cause of deaths as 23.1% and 16.9%, respectively. These pattern showed the change between cancer(14.7%) and cerebrovascular disease(18.5%) in order of frequency in comparison to 1982. Also, the total number of cancer deaths was increased in comparison to 1982. The rate of death certification by physicians was 87.1% of all registered deaths, which was increased to 6.8% in comparison to 1982(80.3%). 2. Crude death rate and cancer specific death rate was 4.06 per 1,000 populations and 93.8 per 100,000 populations(male:117.8, female:70.0), respectively. The former was similar to that of 1982, but the latter was increased to 1.6 times as that of 1982. 3. Age-adjusted cancer specific death rate by standardization with whole country population was 111.9(male:141.5, female:106.7) per 100,000 populations, higher than not age-adjusted cancer specific death rate(93.8), and the sex difference was statistically significant with male predominance(p<0.05). 4. Cancer specific death rate by age was generally increased with age and most of cancer deaths(male:91.8%, female:88.5%) occurred since 40 years old. 5. The major cancer(cancer specific death rate per 100,000 populations) in male was liver(30.6) followed by stomach(25.6), lung(21.9), and GB and EHBD(5.7), in female stomach(15.7), liver(9.9), lung(7.3), and uterus(6.9). The relative frequency of the leading three cancer among total cancer deaths marked 66.3% in male and 47.1% in female, and decreased in comparison to 1982(male:72.2%, female:54.5%). 6. The total ratio of male to female cancer specific death rate showed 1.68 to 1 with male predominance. And the ratio was above 2.0 in larynx, oral cavity & pharynx, esophagus, liver, lung, bladder cancer and the ratio was 1.0~1.9 in stomach, pancreas, gall bladder and EHBD, brain, rectum and anus cancer, leukemia, but the ratio was reversed in thyroid and colon cancer. In conclusion, cancer was the first cause of deaths. The proportion of lung cancer was increased, that of stomach & uterine cancer was decreased relatively, and liver cancer was constantly higher proportion. In the future, it is necessary to conduct the further investigations on the cancer risk factors considering areal specificity.
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- Assessment of Validity of RT-PCR and EIA for The Detection of Hepatitis C Virus Infection.
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Byung Chul Son, Jin Ho Chun, Yeong Hong Park, Hai Rim Shin, Kyu Il Cho, Jong Han Kim, Kui Oak Jung, Jong Tae Lee, Chae Un Lee, Nak Whan Paik
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Korean J Prev Med. 1995;28(2):526-541.
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- This study was conducted to estimate the validity of reverse transcriptase-polymerase chain reaction(RT-PCR) compared to enzyme immunoassay(EIA) for the detection of hepatitis C virus (HCV) infection. ElA for antibody to HCV(anti-HCV) and RT-PCR for HCV was executed on the subjects from Pusan and kyungnam area with questionnaire survey to collect some relating factors of HCV infection As the result from 617 cases, the prevalence of flcv infection was 1.5% by ElA and 3.7% by RT-PCR(p<0.05), and the age standardized rate was 1.7% and 3.4% by ElA and RT-PCR, respectively. The prevalence of hepatitis B surface antigen(HBsAg) was 6.8% by enzyme linked immunosorbent assay(ELlSA) and the age standardized rate was 7.7%. It was the higher in male group comparing to female group(p<0.01). Both of the prevalence of HCV and HBsAg were higher in elevated asparate aminotransferase(AST) and alanine aminotransferase (ALT) group than in normal AST and ALT group(p<0.01). There was no specific risk factor of HCV infection. Though the degree of agreement of EIA and RT-PCR by gamma statistics was 97.2%, it showed a significant difference between the two methods(p<0.01). For the detection of HCV infection, positive predictive value of ElA was 66.7 % and negative predictive value of EIA was 97.2%. This study suggests that negative result to anti-HCV by ElA didn't mean the free state of HCV infection, therefore it would be helpful that further monitoring for HCV infection by RT-PCR in the case of elevated AST and ALT and/or clinically suspected.
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- Risk factors of work-related low back pain in manufacturing workers.
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Dae Hwan Kim, Jung Ho Kim, Hae Lim Shin, Jin Ho Chun, Yong Wan Kim, Chae Un Lee
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Korean J Prev Med. 1993;26(1):20-36.
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- Work-related low back pain is one of the major factors that cause the loss of working power especially in actively working age, therefore controlling the work-related low back pain is one of the major issues in the field of industrial safety and health. This study was performed for detecting the risk factors and proposing the efficient control program of the work-related low back pain. The subjects were male workers employed at the manufacturing industry in Pusan with longer than 6 month's working duration. The data was collected by self-reported questionnaire and interview from May 1 to October 31, 1992. The contents of questionnaire were as follows : the experience of low back within the recent one month, general characteristics(age, marital status, education level, religion, regular exercise), physical characteristics(height, weight), employment status(working duration, daily working hours, rest during work, satisfaction for the job), type of work and working environments(posture, forward bending, lifting and movement, satisfaction for table and chair). The result was analyzed for 608 entire respondents by case-control comparative method. The number of cases was 152 with a history of work-related low back pain, so the relative frequency of self-reported work-related low back pain was 25.0%, and the number of controls was 344 without any history of low back pain. As a result, two characteristics of the employment status(working duration, satisfaction for the job) and all characteristics of type of work and working environments showed a statistical significance between the case and control groups(p<0.01). The Odds ratios of these variables for Work-related low back pain were calculated. They were 7.88 for the satisfaction for chair, 7.86 for lifting and movement, 3.31 for satisfaction for table, and 2.22 for bending forward(p<0.01). And for the multivariate logistic regression analysis confirmed that unsatisfaction for table was independent risk factor for Work-related low back pain. In summary, though this study was based upon the self-reported questionnaire and the subjective complaints, the satisfaction for chair, lifting and movement, satisfaction for table, and bending forward concerned with the type of work and working environments were considered as the main factors causing the work-related low back pain, and the work-related low back pain may be preventable by the ergonomic control of these factors.
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- A study on the productivity of physicians operating clinic in Kyeongsangnamdo.
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Jeong Ho Kim, Kwi Won Jeong, Jin Ho Chun, Chae Un Lee, Ki Taek Pae, Kong Hyun Kim, Hae Rim Shin, Hyung Jong Park
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Korean J Prev Med. 1991;24(2):171-180.
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- Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionnaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The major results were as follows. First, physicians were more prevalent 35~44 group (38.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization, city (78.0%) in geographical location. Age group of 35-54 and specialist were more prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatient load of all physician were 77.1 persons on average. Age group of 35~44 had the most outpatient load (90.3 persons) among all age group, 6~10 years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factorsnumber of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.
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- A Study on the Indoor-Outdoor NO2 Levels and Personal Exposures to NO2 with Analysis of Factors Affecting the NO2 Concentrations: Centering on Urban Homes and Housewives.
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Jin Ho Chun, Chae Un Lee, Joon Youn Kim, Yo Han Chung
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Korean J Prev Med. 1988;21(1):132-151.
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- This study was conducted to establish the control program for preventing unfavorable health effects of nitrogen dioxide(NO2) exposure in homes by preparing the fundamental data for evaluation of relationships between NO2 levels and influencing factors through measurements of indoor-outdoor NO2 levels and personal NO2 exposures for housewives with questionnaire survey on 172 homes in Pusan area from April to June, 1987. NO2 measurements were made by using diffusion tube samplers(Palmes tube NO2 sampler) for one week at 4 sites in homes ; kitchen(KIT), bedroom(BED), living room(LIV), outdoor(OUT) and near the collar housewives(personal exposure livel, PNO). The details of questionnaire were number of household members(FAM), number of regular smokers(SMOKER), daily number of meals eaten(MEAL), type of housing units(HOUSE), location of house with distance from the heavy traffic roads as walking time(DIST), and of kitchen(KAREA), kind of cooking fuels(FUEL), cooking time of each meal(CTIME), usage of kitchen fan for cooking(FAN), type of heating facilities(HEAT) and so on of subject homes. The obtained results were as follows : 1) The mean NO2 level was significantly higher at indoors than outdoors(p<0.01) and the kitchen NO2 level was the highest with 33.7+/-13.6ppb(9.5-81.5ppb). The mean personal exposure level of NO2 for housewives was 20.6+/-8.8ppb(3.1-46.9ppb). 2) The mean indoor NO2 level was significantly higher in the group of household members above 5 than below 4(p<0.05), in detached dwellings than apartments(p<0.001), within 5 minutes of distance than over 5 minutes(p<0.001), in the group of unusing fan(p<0.001), in the group of longer cooking time(p<0.001), and it was in order of coal briquette, gas, electricity and oil by kind of cooking fuels(p<0.05). 3) Variables showing significant correlation(p<0.001) with indoor NO2 level were kitchen NO2 level(r=0.8677), cooking time(r=0.5921), outdoor NO2 exposure level(r=0.4615), usage of kitchen fan(r=0.3573) and location of house(r=-0.2988). 4) As a result of multiple regression analysis, the most significant influencing variable to the kitchen NO2 level was cooking time [KIT=-0.378+/-11.772(CRIME)+0.298(OUT)+3.102(FAN)], it was kitchen NO2 level to the indoor NO2 level [IND = 6.996+0.458 (KIT) + 0.230 (OUT) - 1.127 (KAREA)], and it was indoor NO2 level to the personal NO2 exposure level [PNO=15.562+0.729(IND)-4.542(DIST)-0.200(KIT)]. 5) It was recognized that artificial ventilation in the kitchen, suppression of unnecessary combustion and replacement of cooking fuel, as much as possible, were effective means for decreasing indoor NO2 levels in homes.
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