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Yoon Ok Ahn 31 Articles
Power Estimation and Follow-Up Period Evaluation in Korea Radiation Effect and Epidemiology Cohort Study.
In Seong Cho, Minkyo Song, Yunhee Choi, Zhong Min Li, Yoon Ok Ahn
J Prev Med Public Health. 2010;43(6):543-548.
DOI: https://doi.org/10.3961/jpmph.2010.43.6.543
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  • 2 Crossref
AbstractAbstract PDF
OBJECTIVES
The objective of this study was to calculate sample size and power in an ongoing cohort, Korea radiation effect and epidemiology cohort (KREEC). METHOD: Sample size calculation was performed using PASS 2002 based on Cox regression and Poisson regression models. Person-year was calculated by using data from '1993-1997 Total cancer incidence by sex and age, Seoul' and Korean statistical informative service. RESULTS: With the assumption of relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, sample size calculation was 405 events based on a Cox regression model. When the relative risk was assumed to be 1.5 then number of events was 170. Based on a Poisson regression model, relative risk=1.3, exposure:non-exposure=1:2 and power=0.8 rendered 385 events. Relative risk of 1.5 resulted in a total of 157 events. We calculated person-years (PY) with event numbers and cancer incidence rate in the non-exposure group. Based on a Cox regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, 136 245PY was needed to secure the power. In a Poisson regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, person-year needed was 129517PY. A total of 1939 cases were identified in KREEC until December 2007. CONCLUSIONS: A retrospective power calculation in an ongoing study might be biased by the data. Prospective power calculation should be carried out based on various assumptions prior to the study.
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  • Comparative Analysis of Driver Mutations and Transcriptomes in Papillary Thyroid Cancer by Region of Residence in South Korea
    Jandee Lee, Seonhyang Jeong, Hwa Young Lee, Sunmi Park, Meesson Jeong, Young Suk Jo
    Endocrinology and Metabolism.2023; 38(6): 720.     CrossRef
  • Cancer Risk in Adult Residents near Nuclear Power Plants in Korea - A Cohort Study of 1992-2010
    Yoon-Ok Ahn, Zhong Min Li
    Journal of Korean Medical Science.2012; 27(9): 999.     CrossRef
Reliability of Covariates in Baseline Survey of a Cohort Study: Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea.
Sanghyuk Bae, Bo Young Park, Zhong Min Li, Yoon Ok Ahn
J Prev Med Public Health. 2010;43(2):159-165.
DOI: https://doi.org/10.3961/jpmph.2010.43.2.159
  • 4,888 View
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  • 1 Crossref
AbstractAbstract PDF
OBJECTIVES
We evaluated the reliability of the possible covariates of the baseline survey data collected for the Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea. METHODS: Follow-up surveys were conducted for 477 participants of the cohort at less than 1 year after the initial survey. The mean interval between the initial and follow-up surveys was 282.5 days. Possible covariates were identified by analyzing the correlations with the exposure variable and associations with the outcome variables for all the variables. Logistic regression analysis with stepwise selection was further conducted among the possible covariates to select variables that have covariance with other variables. We considered that these variables can be representing other variables. Seven variables for the males and 3 variables for the females, which had covariance with other possible covariates, were selected as representative variables. The Kappa index of each variable was calculated. RESULTS: For the males, the Kappa indexes were as follow; family history of cancer was 0.64, family history of liver diseases in parents and siblings was 0.56, family history of hypertension in parents and siblings was 0.51, family history of liver diseases was 0.50, family history of hypertension was 0.44, a history of chronic liver diseases was 0.53 and history of pulmonary tuberculosis was 0.36. For females, the Kappa indexes were as follow; family history of cancer was 0.58, family history of hypertension in parents and siblings was 0.56 and family history of hypertension was 0.47. CONCLUSIONS: Most of the possible covariates showed good to moderate agreement.
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  • Cancer Risk in Adult Residents near Nuclear Power Plants in Korea - A Cohort Study of 1992-2010
    Yoon-Ok Ahn, Zhong Min Li
    Journal of Korean Medical Science.2012; 27(9): 999.     CrossRef
Ten Year Trend of Cancer Incidence in Seoul, Korea: 1993-2002.
Myung Hee Shin, Hyun Kyung Oh, Yoon Ok Ahn
J Prev Med Public Health. 2008;41(2):92-99.
DOI: https://doi.org/10.3961/jpmph.2008.41.2.92
  • 4,877 View
  • 34 Download
  • 23 Crossref
AbstractAbstract PDF
OBJECTIVES
Effective cancer prevention and control measures can only be done when dependable data on the cancer incidence is available. The Seoul Cancer Registry (SCR) was founded to provide valid, comparable and representative cancer incidence data for Koreans. We aimed to compare the cancer incidence in the first (1993-1997) and second term (1998-2002) of the SCR, and we analyzed the annual incidence trend during that 10 years. METHODS: The SCR detects potential cancer cases through the Korean Central Cancer Registry (KCCR) data, the health insurance claims, the individual hospital's discharge records and the death certificates. About 87% of the SCR data is registered through the KCCR. The rest of the data is registered by SCR registrars who visit about 70~80 mid-sized hospitals in Seoul to review and abstract the medical records of the potential cancer patients. RESULTS: The total number of new cancer cases was higher in 1998~2002 than in 1993~1997 by 20.6% for men and 18.4% for women, respectively. The age-standardized rate (ASR) of total cancer per 100,000 increased 1% (from 295.4 to 298.3) for men and 5.1% (from 181.5 to 190.7) for women, between the two periods. The commonest cancer sites during 1998-2002 for men were stomach, liver, bronchus/lung, colorectum, bladder and prostate, and the commonest cancer sites for women were breast, stomach, colorectum, cervix uteri, thyroid and bronchus/lung. Compared with the ASRs in 1993, the ASRs in 2002 increased for colorectum (58.4% for men, 27.1% for women), prostate (81.5%), breast (58.3% for women), thyroid (141% for women), and bronchus/lung (15.4% for women). The ASRs for stomach (-18.7% for men, -20.7% for women) and uterine cervix cancer (-39.7%) had decreased. CONCLUSIONS: The cancer incidence is increasing in Seoul, Korea, especially for the colorectum and prostate for men, and for the breast, colorectum, bronchus/lung and thyroid for women.
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  • Changes of Clinicopathologic Characteristics and Survival Outcomes of Anaplastic and Poorly Differentiated Thyroid Carcinoma
    Doh Young Lee, Jae-Kyung Won, Se-Hoon Lee, Do Joon Park, Kyeong Cheon Jung, Myung-Whun Sung, Hong-Gyun Wu, Kwang Hyun Kim, Young Joo Park, J. Hun Hah
    Thyroid.2016; 26(3): 404.     CrossRef
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    Asian Pacific Journal of Cancer Prevention.2016; 17(3): 1493.     CrossRef
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    Journal of the Korea Academia-Industrial cooperation Society.2015; 16(2): 1292.     CrossRef
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    Jun Hyun Hwang, Dong Hee Ryu, Soon-Woo Park
    Journal of Korean Medical Science.2015; 30(8): 1017.     CrossRef
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    Ji Min Choi, Sang Gyun Kim
    The Korean Journal of Medicine.2015; 89(2): 157.     CrossRef
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    Sang Gyun Kim, Hye‐Kyung Jung, Hang Lak Lee, Jae Young Jang, Hyuk Lee, Chan Gyoo Kim, Woon Geon Shin, Ein Soon Shin, Yong Chan Lee
    Journal of Gastroenterology and Hepatology.2014; 29(7): 1371.     CrossRef
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    Hyuk Lee, Hye-Kyung Jung, Kyu Chan Huh
    The Korean Journal of Internal Medicine.2014; 29(2): 156.     CrossRef
  • Overview of Cancer Registration Research in the Asian Pacific from 2008-2013
    Malcolm A. Moore
    Asian Pacific Journal of Cancer Prevention.2013; 14(8): 4461.     CrossRef
  • Effect of Rubus coreanus Miquel on prostate tumour growth
    Eun Young Baek, Seung Min Lee, Jung eun Lee, Eunkyo Park, Yuri Kim, In-Kyung Jung, Jung-Hyun Kim
    Journal of Functional Foods.2013; 5(3): 1478.     CrossRef
  • Thyroid Cancer is the Most Common Cancer in Women, Based on the Data from Population-based Cancer Registries, South Korea
    S.-S. Kweon, M.-H. Shin, I.-J. Chung, Y.-J. Kim, J.-S. Choi
    Japanese Journal of Clinical Oncology.2013; 43(10): 1039.     CrossRef
  • A Study on Ten Years Trend of Cancer Incidence and Evaluation of Quality of Cancer Registration in Daejeon Metropolitan City and Chungcheongnam-Do, Korea: 2000-2009
    Un-Je Park, Hae-Seong Nam, Kwang-Hwan Kim, Chang-Soo Park, In-Sun Kwon, Jeong-A Kim, Tae-Yong Lee
    Journal of the Korea Academia-Industrial cooperation Society.2013; 14(3): 1234.     CrossRef
  • Guidelines for the Diagnosis and Treatment ofHelicobacter pyloriInfection in Korea, 2013 Revised Edition
    Sang Gyun Kim, Hye-Kyung Jung, Hang Lak Lee, Jae Young Jang, Hyuk Lee, Chan Gyoo Kim, Woon Geon Shin, Ein Soon Shin, Yong Chan Lee
    The Korean Journal of Gastroenterology.2013; 62(1): 3.     CrossRef
  • Recurrence of Colorectal Neoplasm Cannot Be Predicted by Sonic Hedgehog Expression in the Normal Colonic Tissue
    Ji Young Lee, Sun-Young Lee, Hye Seung Han, So Young Kim, Sung Noh Hong, Jeong Hwan Kim, In Kyung Sung, Hyung Seok Park, Chan Sup Shim, Choon Jo Jin
    Intestinal Research.2012; 10(3): 265.     CrossRef
  • Current status of robotic colorectal surgery
    Jung Myun Kwak, Seon Hahn Kim
    Journal of Robotic Surgery.2011; 5(1): 65.     CrossRef
  • The Prevalence and Features of Korean Gout Patients Using the National Health Insurance Corporation Database
    Chan Hee Lee, Na Young Sung
    Journal of Rheumatic Diseases.2011; 18(2): 94.     CrossRef
  • Characteristics of Gastric Cancer in Korea - with an Emphasis on the Increase of the Early Gastric Cancer (EGC)
    Ki Joo Kang, Jun Haeng Lee
    Journal of the Korean Medical Association.2010; 53(4): 283.     CrossRef
  • Diagnosis of Functional Dyspepsia: a Systematic Review
    Hye-kyung Jung, Bo Ra Keum, Yoon Ju Jo, Sam Ryong Jee, Poong-Lyul Rhee, Young Woo Kang
    The Korean Journal of Gastroenterology.2010; 55(5): 296.     CrossRef
  • Differences in Expression of VEGF-A, VEGFR-1, VEGFR-2 and Microvessel Density in Colorectal Cancer with Liver Metastasis
    Eun Hui Jeong, Young Kim, Byeong Woo Min, Kyung Hwa Lee, Hyun Soo Kim, Jae Hyuk Lee
    The Korean Journal of Pathology.2010; 44(6): 571.     CrossRef
  • Colonoscopy screening for individuals aged 40–49 years with a family history of stomach cancer in Korea
    Yong Sung Choi, Jung Pil Suh, Doo Seok Lee, Eui Gon Youk, In Taek Lee, Suk Hee Lee, Do Sun Kim, Doo Han Lee
    International Journal of Colorectal Disease.2010; 25(4): 443.     CrossRef
  • Cancer in Patients on Chronic Dialysis in Korea
    Jung Eun Lee, Seung Hyeok Han, Byoung Chul Cho, Jung Tak Park, Tae Hyun Yoo, Beom Seok Kim, Hyeong Cheon Park, Shin-Wook Kang, Ho Yung Lee, Dae-Suk Han, Sung Kyu Ha, Kyu Hun Choi
    Journal of Korean Medical Science.2009; 24(Suppl 1): S95.     CrossRef
  • A Phase II Trial of Paclitaxel, 5-fluorouracil (5-FU) and Cisplatin in Patients with Metastatic or Recurrent Gastric Cancer
    Gun Hi Kang, Gwang Sil Kim, Hyo Rak Lee, Young Jin Yuh, Sung Rok Kim
    Cancer Research and Treatment.2008; 40(3): 106.     CrossRef
  • Socioeconomic Disparities in Breast Cancer Screening among US Women: Trends from 2000 to 2005
    Jaeyoung Kim, Soong-Nang Jang
    Journal of Preventive Medicine and Public Health.2008; 41(3): 186.     CrossRef
Cancer Registration in Korea: The Present and Furtherance.
Yoon Ok Ahn
J Prev Med Public Health. 2007;40(4):265-272.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.265
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  • 72 Download
  • 19 Crossref
AbstractAbstract PDF
It was not until 1975 that cancer registration was initiated in Korea; voluntary registration of cancer patients of training hospitals throughout the country began under the auspices of the Korean Cancer Society(KCS). However, an official cancer registration, the Korea Central Cancer Registry(KCCR), began on July 1st, 1980. Forty-five training and two non-training hospitals throughout the country initiated registration of patients in whom neoplasms had been found. Data related to case information specified are to be sent to the KCCR at the National Medical Center(it moved at National Cancer Center in 2000). The initial cancer registration of KCS was merged to the KCCR in 1980. Although the KCCR covers most all the large training hospitals in Korea, it cannot provide incidence data. It is, however, the only of its kind in the world, being neither hospital nor population based. The first population based cancer registry(PBCR) was launched in a small county, Kangwha(it has around 80,000 inhabitants), by Yonsei University Medical College in 1983. All data were collected by active methods, and incidence statistics for 1986-1992 appeared in Vol VII of the CI5. Another PBCR, Seoul Cancer Registry(SCR), started in 1991. It was supported by a civilian foundation, the Korean Foundation for Cancer Research. The basic idea of case registration of SCR was the incorporation of KCCR data to PBCR, e. g. dual sources of case registration, i.e., from the KCCR and also including cases diagnosed in small hospitals and other medical facilities. Assessing completeness and validity of case registration of SCR, the program and methodology used by the SCR was later extended to other large cities and areas in Korea, and the PBCR in each area was established. Cancer incidence statistics of Seoul for 1993- 1997, Busan for 1996-1997, and Daegu for 1997-1998, as well as Kangwha for 1993-1997, appeared eventually in Vol VIII of the CI5. The Korean or 'pillar' model for a PBCR is a new one. The KCCR data file is a reliable basis, as a pillar, for a PBCR in each area. The main framework of the model for such a registry is the incorporation of a KCCR data file with data from additionally surveyed cases; the data related to cancer deaths, medical insurance claims, and visit-and abstract surveillance of non-KCCR medical facilities. Cancer registration has been adopted as a national cancer control program by Korean government in 2004 as the Anti-Cancer Act was enacted. Since then, some officers have tried to launch a nation-wide PBCR covering whole country. In the meantime, however, cancer registration was interrupted and discontinued for years due to the Privacy Protection Law, which was solved by an amendment of the Anti-Cancer Act in 2006. It would be premature to establish the nation-wide PBCR in Korea. Instead, continuous efforts to improve the completeness of registration of the KCCR, to progress existing PBCRs, and to expand PBCRs over other areas are still to be devoted. The nation-wide PBCR in Korea will be established eventually with summation of the PBCRs of the Korean model.
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    Hyeong Sik Ahn, Hyun Jung Kim, Kyoung Hoon Kim, Young Sung Lee, Seung Jin Han, Yuri Kim, Min Ji Ko, Juan P. Brito
    Thyroid.2016; 26(11): 1535.     CrossRef
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    PLoS ONE.2014; 9(11): e112184.     CrossRef
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  • Ten Year Trend of Cancer Incidence in Seoul, Korea: 1993-2002
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Seasonal Variation of Food Intake in Food Frequency Questionnaire among Workers in a Nuclear Power Plant.
Jae Jeong Yang, Sue Kyung Park, Hyun Sul Lim, Kwang Pil Ko, Younjhin Ahn, Yoon Ok Ahn
J Prev Med Public Health. 2007;40(3):239-248.
DOI: https://doi.org/10.3961/jpmph.2007.40.3.239
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to investigate the systematic error, such as seasonal change or inadequate food items, in a food frequency questionnaire administered to workers in a Nuclear Power Plant, Korea. METHODS: We performed three repeat-tests with 28 subjects on May 13, July 8 and Dec 16, 1992. Our food frequency questionnaire (FFQ) comprised 84 foods organized into 7 food-groups, and was composed of the items of usual intake frequency (8 categories) and the amount per intake (3 or 4 categories) over the previous year. We compared the means of intake frequency and the frequency of the portion-size according to each season using Repeated Measures ANOVA and Pearson's chisquare test with Fisher's exact test. RESULTS: We found the significant seasonal changes of several food items in intake frequency measurement. These items were typical seasonal foods such as mandarin orange, plum and green vegetables, while the single questions consisted of inadequate food items such as thick beef or similar soup and various kimchi products. Significant seasonal changes in portion-size were found in only two items: cooked rice-brown and fresh.frozen fishes. CONCLUSIONS: The systematic errors observed could caused loss of validity in the FFQ. Consideration should be given for seasonal variation in FFQ survey and methodological concerns are needed to improve the quality for measuring usual diet pattern.
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A Study on the Seropositivity of HBsAg among Biennial Health Examinees: A Nation-wide Multicenter Survey.
Dae Sung Kim, Young Sik Kim, Jae Yong Kim, Yoon Ok Ahn
Korean J Prev Med. 2002;35(2):129-135.
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AbstractAbstract PDF
OBJECTIVE
The primary objective of this study was to estimate the prevalence of HBsAg-positives in the late 1990's among Korean adults. In addition, we evaluated the association of age, a residential area, a vaccination rate, a family history of chronic liver diseases and a past history of acute liver disease with the seropositivity of HBsAg, and estimated the prevalence of chronic HBV infection by follow-up for 6 month or more. METHODS: A total of 10 areas, six metropolitan and four small cities, were selected. In each cities, one health screening center was selected for recruitment of study subjects. The study subjects were enrolled from a general health examination program that is provided by medical insurance companies. Questionnaires on various risk factors were administered to the study subjects. Sera was drawn and tested for HBsAg by radioimmunoassay. HBeAg and ALT were also tested for those of HBsAg positive. The HBsAg positives was retest for HBsAg 6 months later. RESULTS: Among the study subjects (n= 1816), the seroprevalence of HBsAg was 5.5% (95% CI= 4.5%-6.6%), 7.4% in men (95% CI= 5.8-9.4) and 3.6% in women (95% CI= 2.5-5.0). A past history of acute liver disease and a family history of chronic liver diseases was shown to be risk factors for HBsAg positivity. Among the 31 HBsAg-positives, negative seroconversion rate was estimated to be 3.2 %, Thus, prevalence of chronic HBV infection was estimated to be 5.3% (95% CI= 3.7-6.6). CONCLUSION: In this study, the HBsAg seroprevalence rate was lower than that of the other studies in 1980's, particularly in young adult and women. Considering the public health importance of liver cancer and chronic liver diseases, the further effort is needed to prevent and reduce the HBV infection.
Summary
Hepatitis B Virus DNA Mutation, Pattern of Major Histocompatibility Class-I among Familial Clustered HBV Carriers in Relation to Disease Progression .
Seung Pil Jung, Hyo Suk Lee, Chung Yong Kim, Yoon Ok Ahn
Korean J Prev Med. 2000;33(3):323-333.
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AbstractAbstract PDF
OBJECTIVES
Chronic HBsAg carriers are the principal source of infection for other susceptible people, and are themselves at high risk of developing serious liver diseases. In Korea, it has been estimated that 65-75% of the HBsAg positives remained as persistent carriers. Additionally, familial clustering of HBV infection has frequently been observed among carriers. Some would become progressive, chronic hepatitis patients, and others would not. The aim of this study was to evaluate the association between various factors, such as the duration of infection, type of virus, mutation of precore/core region in HBV, major histocompatibility class-I, and developing chronic liver diseases among familial HBV carriers. METHODS: Chronic carrier status was identified by repeated serological tests for HBsAg at intervals of six months or more. A familial chronic carrier was defined when the disease was observed in a family member over two generations. Two families were recruited, among which a total of 20 chronic HBsAg carriers(11 carriers in No.1, and 9 in No.2 family) were identified. Data on the general characteristics and liver disease status were collected. Identification of the HBV-DNA was successful only for 13 subjects among the 20 carriers. Analysis of viral DNA in terms of subtype, pre-core and core region mutations was carried out. The type of major histocompatibility class-I for the 13 subjects was also analysed. RESULTS & CONCLUSIONS: Seven of 10 chronic HBV carriers of the 1st generation and one of 10 of the 2nd generation were clinical patients with chronic hepatitis, the others, three of the 1st and nine of the 2nd generation, were asymptomatic carriers. This data indicates that the duration of HBV carriage is one of the major factors for disease severity. The subtype of HBsAg analysed using HBV-DNA identified in 13 carriers were adr, and the pattern of precore nonsense mutation in HBV-DNA was identical among family members, which means that the same virus strains were transmitted between the family members. The association between the precore or core mutations in HBV-DNA and the disease severity was not observed. While it was suggested that a specific type of MHC class-I may be related to disease progression.
Summary
Incidence and Risk Factors for Diabetes Mellitus in Korean Middle-aged Men: Seoul Cohort DM Follow-up Study.
Dong Hyun Kim, Yoon Ok Ahn, Sung Woo Park, Moon Gi Choi, Dae Sung Kim, Moo Song Lee, Myung Hee Shin, Jong Myon Bae
Korean J Prev Med. 1999;32(4):526-537.
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OBJECTIVES
It is known that the prevalence of diabetes mellitus(DM) appears to be rapidly increasing in recent times in Korea, presumably due to a westernized diet and change of life style followed by rapid economic growth. Based on the Seoul male cohort which was constructed in 1993, this study was conducted to estimate the annual incidence rates of DM through 4 years' follow up and to determine which factors are associated with DM risk in Korean middle-aged men. METHODS: Among 14,533 men recruited at baseline, 559 were excluded because they reported a history of diabetes or were found to be diabetes at 1992 routine health examination. During 4 years follow-up, 237 incident DM cases were ascertained through chart reviews and telephone contacts for those who have ever visited hospitals or clinics under suspicion of DM during 1993-1996 and the biennial routine health examinations in 1994 and 1996. RESULTS: In this study the annual incidence of DM among the study population was estimated to be 0.5 per 100. This study showed that fasting glucose level at initial baseline examination was a powerful predictor of risk for diabetes several years later(fasting blood glucose of > or = 110 mg/dl compared with < or = 80 mg/dl, Hazard Ratio[HR]=15.6, 95% Confidence interval[CI]=9.1-26.6) after considering potential covariates such as age, family history, smoking and alcohol history, body mass index, physical activity, total energy intake, and total fiber intake. Adjusted hazard ratios of family history of diabetes was 1.95(95% CI=1.38-2.75); of obesity as measured by BMI(BMI > or = 25.3 compared with < or = 21.3) was 7.19(95% CI=3.75-13.8); of weight change during middle life(>10kg compared with 5) was 1.77(95% CI=1.16-2.69); of smoking(current vs none) was 1.93(95% CI=1.06-3.51); and fat intake(upper tertile compared with lower tertile) was 1.88(95% CI=1.01-3.49), while fiber intake was associated with the reduced risk(HR=0.36, 95% CI=0.19-0.67). CONCLUSION: The factors identified in this study indicate that the greatest reduction in risk of diabetes might be achieved through population-based efforts that promote fiber intake and reduce obesity, smoking, and fat intake.
Summary
A Nested Case-Control Study on the High Normal Blood Pressure as a Risk Factor of Hypertension in Korean Middle-aged Men.
Jong Myon Bae, Yoon Ok Ahn
Korean J Prev Med. 1999;32(4):513-525.
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OBJECTIVES
'High-normal blood pressure' is a factor influencing decision to initiate targeted intensive intervention strategy in westernized populations. JNC-VI offered the vigorous lifestyle modification for persons with 'high-normal blood pressure', who could be early detected. As a hypertension seems to be the result of multiple genetic factors operating in concert with associated environmental factors, it will be necessary to identify the high-normal blood pressure as a risk factor of hypertension for applying primary prevention strategy in Korean people. METHODS: Although cohort study design might be adequate to recruit incidence cases, to keep time sequence of events, and to prevent information bias, nested case-control study was chosen for avoiding measurement errors because hypertension is a benign disease. Source population was the 'Seoul Cohort' participants and follow-up was done by using Korea Medical Insurance Corporation's database on the utilization of health services from 1Jan93 to 30Jun97. Incidence cases were ascertained through the chart review, telephone contacts, and direct blood pressure measurements. Controls included the pairing of 4 individuals to each case on the basis of age. RESULTS: As 75 % of 247 incident cases had high-normal blood pressure, the crude odds ratio for hypertension was 2.04 (95% CI 1.47-2.83). Another statistically significant risk factors of hypertension were body mass index, dietary fiber, alcohol consumption, weekly activity and history of quitting smoking. The multivariate odds ratio of high-normal blood pressure adjusted for all risk factors was 1.84 (95 % CI 1.31-2.56). Among high-normal blood pressure group, body mass index, weekly ethanol amounts, weekly physical activity, and dietary fiber except history of quitting smoking were still risk factors of hypertension. CONCLUSION: 'High-normal blood pressure' is a risk factor for hypertension in Korean middle-aged men, which represents that the vigorous lifestyle modification for persons with 'high-normal blood pressure' is need.
Summary
A Cohort Study on Risk Factors for Chronic Liver Disease: Analytic Strategies Excluding Potentially Incident Subjects.
Moo Song Lee, Dae Sung Kim, Dong Hyun Kim, Jong Myun Bae, Myung Hee Shin, Yoon Ok Ahn
Korean J Prev Med. 1999;32(4):452-458.
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OBJECTIVES
The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. METHODS: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox' model were used for potentially diseased group, other members, and total subjects, respectively. RESULTS: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk, while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. CONCLUSIONS: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.
Summary
A Distribution of Waist-hip Ratio Associated with the Blood Pressure in Middle-aged Men.
Jong Myon Bae, Dae Sung Kim, Jaiyong Kim, Yoon Ok Ahn
Korean J Prev Med. 1999;32(3):395-399.
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BACKGROUND
Excess abdominal fat, expressed as an increased ratio of waist to hip circumferences (WHR), is independently associated with higher levels of blood pressure. Although a WHR greater than 1.0 in men has been shown to predict complications from obesity, the WHR has not been evaluated in all ethnic groups. METHODS: In order to ascertain the association between WHR and classification of blood pressure and to investigate the critical value of WHR as a predictive factor of hypertension in Korean middle-aged men, we compared the mean of WHRs according to the classification of blood pressure in Seoul Cohort participants. RESULTS: Through a survey of direct measurement of waist and hip girth, 452 subjects were recruited from the cohort. The mean of WHR was 0.88 and its standard deviation was 0.04. The mean of WHRs was higher in the systolic blood pressure group (above 140 mmHg), diastolic blood pressure group (above 90 mmHg), and hypertension group than in the systolic blood pressure group (below 140 mmHg), diastolic blood pressure group (below 90 mmHg), and normotensive group, respectively. And WHR of above 0.89 was associated with hypertension (z-value =6.66). CONCLUSIONS: It is necessary for Korean males with WHR greater than 0.89 to recommend the primary prevention and early detection of hypertension.
Summary
A Cohort Study of Physical Activity and All Cause Mortality in Middle-aged Men in Seoul.
Dae Sung Kim, Hye Won Koo, Dong Hyon Kim, Jong Myon Bae, Myung Hee Shin, Moo Song Lee, Chung Min Lee, Yoon Ok Ahn
Korean J Prev Med. 1998;31(4):604-615.
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Although previous studies revealed the association of physical activity with mortality rate, it is unclear whether there is a linear trend between physical activity and mortality rate. In this study, the association of physical activity with the risk of all-cause mortality was analysed using Cox's proportional hazard model for a cohort of 14,204 healthy Korean men aged 40-59 years followed up for 4 years(Jan. 1993 - Dec. 1996). Physical activity and other life style were surveyed by a postal questionnaire in December 1992. Total of 14,204 subjects were grouped into quartiles by physical activity. Using death certificate data, 123 deaths were identified. The second most active quartile had a lowest mortality rate with relative risk of 0.44(95% C.I.: 0.23-0.84) compared with most sedentary quartile, showing a J-shape pattern of physical activity-mortality curve. By examining the difference in proportion of cause of the death between most active quartile and the other quartiles, there was no significant difference of proportional mortality from cardiovascular deaths, cerebrovascular deaths or deaths from trauma. The covariates were stratified into two group between which the trend of RR was compared to test the effect modification. There was no remarkable effect modification by alcohol intake, smoking, body mass index, calorie consumption, percent fat consumption. In conclusion, moderate activity was found to have more protective effect on all-cause mortality than vigorous activity and that the J-shape pattern of physical activity-mortality curve was not due to the difference of mortality pattern or effect modification by alcohol intake, smoking, body mass index, calorie consumption and percent fat consumption.
Summary
Seroepidemiologic Study of Hepatitis B Virus(HBV) and Hepatitis C Virus(HCV) Infection among Koreans in Rural Area, Korea.
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
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.
Summary
Nationwide Incidence Estimation of Uterine Cervix Cancer among Korean Women.
Byung Joo Park, Moo Song Lee, Yoon Ok Ahn, Young Min Choi, Yeong Su Ju, Keun Young Yoo, Hun Kim, Ha Seung Yew, Tae Soo Park
Korean J Prev Med. 1996;29(4):843-852.
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To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation(KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: 16.76~17.92) per 100,000 and the cumulative rates for the ages 0~64 and 0~74 were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in 1983~1987. The truncated rate for ages 35~64 was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged 55~59 years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.
Summary
Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults.
Jong Myon Bae, Byung Joo Park, Moo Song Lee, Dong Hyun Kim, Myung Hee Shin, Yoon Ok Ahn
Korean J Prev Med. 1996;29(4):801-814.
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BACKGROUND
Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. METHODS: Study subjects were drawn from male members of seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hundred per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. RESULTS: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. CONCLUSION: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.
Summary
A Case-Control Study on Risk Factors of Uterine Cervix Cancer in Korea.
Hye Won Koo, Keun Young Yoo, Dong Hyun Kim, Yong Sang Song, No Hyun Park, Soon Beom Kang, Hyo Pyo Lee, Yoon Ok Ahn, Chae Un Lee
Korean J Prev Med. 1996;29(2):159-172.
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A hospital-based case-control study was carried out to investigate the risk factors of uterine cervical cancer in korea. Information on a wide-range of life-styles, which might be related with uterine cervix cancer, has been routinely collected through a dual application of the self-administered questionnaire and the direct interview by a well-trained nurse at the Department of Gynecology, Seoul National University Hospitals since 1992. The number of cervical cancer cases, histologically confirmed at the hospital, were 284. Included were 939 women as controls, who were free of past history of any malignancies. Adjusted odds ratio and 95% confidence limits were based on the unconditional logistic regression model. The multivariate logistic model was constructed under the consideration of biologic characteristics on the natural history of the malignancy. In the multivariate results, the uterine cervical cancer risk was higher in women of shorter height(P(trend) <0.05), less educated spouse (P(trend) < 0.001), multiple marriages(adjusted OR=2,70,95% C.I. 1.64~4.47), ever had a family history (adjusted OR=2.14., 95 % C.I. l.18~3.89), multiparity (P(trend) < 0.001), and early age at first delivery (P(trend) < 0.001). These results strongly suggest that the uterine cervix cancer might be related to the reproductive factors, and probably with sexual behaviour of both women and men in Korea.
Summary
Evaluation of the Completeness and Validity of the Registration in the Implementation Study of Seoul Cancer Registry(ISSCR).
Myung Hee Shin, Yoon Ok Ahn
Korean J Prev Med. 1994;27(4):735-746.
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The incidence data(1991.7.1~1992.6.30)from the Implementation study of seoul cancer Registry(lSSCR) were evaluated in terms of its completeness and validity. Two indicators for the completeness, Mortality/Incidence ratio(M/I ratio) and Age-specific Incidence Curve, showed fairy good registration throughout the age-sex specific strata, except the strata aged over 75 years old. The strata had very high M/I ratio(over 100%) and decreasing pattern of incidence, which suggested incomplete registration of cancer in this group. The active surveillance by a ISSCR staff improved the registration rate especially among elderlies. From the site specific M/I ratio, we found that liver cancer had oddly high M/I ratio. Since this high M/I ratio of liver cancer appears consistently in other reliable cancer registries, it is more like to be due to the highfatality of it rather than incomplete registration. The validity of the incidence data was assessed by three indicators; Histological verification (HV%), Primary Site Unknown (PSU%), and Age Unknown(Age UNK%). The average HV% were 77% for men and 85% for women, which were slightly lower than those of other reliable cancer registries This low HV% might be due to the considerable size of relative frequency of liver cancer in Korea, regarding the fact that the diagnosis of liver cancer is made mostly by non-biopsical radiologic methods (CT, Ultrasono, Angiography, MRl etc.). The level or PSU% and Age UNK% were in acceptable range, but not low enough, especially in terms of Age UNK%. Although ISSCR data had acceptable quality in general, it is needed to have more hospitals participate in the registry surveillance, to make registry data merged with death certificate data regularly, and educate the registration staffs to be more competent and dedicated.
Summary
Survey Methods on Cancer Epidemic.
Byung Joo Park, Jong Myon Bae, Yoon Ok Ahn, Keun Young Yoo
Korean J Prev Med. 1994;27(3):411-424.
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The survey methods for confirming the epidemicity and identifying the possible causes of the cancer epidemic can be different from those for infectious diseases. The procedure for confirming whether the outbreak is epidemic or not is quite different. Household survey for identifying cancer cases and residents actually living at the area should be done. Hospital survey for medical record review should be performed to identify all cancer cases among the residents of the outbreak area and confirming the final diagnoses of the cancer cases. Comparing the level of cancer incidence or mortality with other areas can be done by using poison distribution, or calculating SIR (standard Incidence Ratio) from cumulative incidence rates. Case-control study can be conducted to identify the etiologic factors of the cancer epidemic and to establish strategy for preventing further recurrence of the outbreak.
Summary
A Case-Control Study of Primary Liver Cancer and Liver Disease History.
Dong Hyun Kim, Byung Joo Park, Keun Young Yoo, Yoon Ok Ahn, Hyo Suk Lee, Chung Yong Kim, Sang Il Lee, Moo Song Lee, Hyung Sik Ahn, Heon Kim, Tae Soo Park
Korean J Prev Med. 1994;27(2):217-225.
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AbstractAbstract PDF
The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age-and sex-matched 165 controls in hospital for ophthalmologic, ontologic, or nasopharyngeal problems. Significant association were observed for liver diseases occurring 5 or more years before liver cancer diagnosis[OR, 4.9;97% confidence interval(CI), 1.6~14.0) and family history of liver disease(OR, 9.0;95% CI, 2.1~38.8). These associations were mot appreciably modified by allowance for major identified potential confounding factors, From these results, it is possible to speculate that liver cell injuries caused by Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.
Summary
The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men.
Myung Hee Shin, Dong Hyun Kim, Jong Myun Bae, Hyung Ki Lee, Moo Song Lee, Joon Yang Noh, Yoon Ok Ahn
Korean J Prev Med. 1994;27(2):200-216.
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AbstractAbstract PDF
In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices(e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.)through the program of biennial health check-up offered by Korean Medical Insurance Corporation(KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were -0.4+/-3.56mg/dl for those drinking less than 1 cup a day, -0.6+/-3.60mg/dl for those drinking 1 cup a day, and 7.1+/-3.41mg/dl for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total cholesterol, we re-analyzed those relationship in smokers and non-smokers separately. Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index(cigarette-years; r=0.10), Quetelet's index(kg/m2, r=0.16), daily calory expenditure(kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption(g/week, r=0.08), other caffeinated beverage intake(cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index(in smokers)were remained in the models. After adjustment, the corresponding differences of total cholesterol in smokers were changed to 0.4+/-5.24mg/dl, -0.5+/-4.97mg/dl, and 8.9+/-4.78mg/dl, which were significantly different among themselves(P=0.011). In non-smokers, however, the differences were not statistically significant(P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, P=0.48 for DBP). Assuming instant coffee on the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers , is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.
Summary
Association of Stress Level with Smoking Amounts among University Students.
Jong Myon Bae, Yoon Ok Ahn, Byung Joo Park
Korean J Prev Med. 1994;27(1):1-10.
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AbstractAbstract PDF
The aim of this study was to assess the degree of association between individual stress and the amount of smoking among male senior students of a medical college. The questionnaire survey was conducted twice for collecting the data on stress level in terms of BEPSl score, smoking amounts, alcohol intake, and residence type in 1992 and 1993. Among the 223 responders, 39.9% were smokers. In the smokers, the association between stress level and smoking amount was significant after controlling for alcohol intake and residence type (P < 0.l). Especially in the group of living without family, the association was more significant (p=0.06). Therefore, it is recommendable that the stress management program is called upon for the student smokers to reduce smoking amount.
Summary
Estimation of Cancer Mortality among Koreans with Reference to Kyongsangnam-do Area.
Moo Song Lee, Tae Soo Park, Yoon Ok Ahn
Korean J Prev Med. 1992;25(2):115-126.
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AbstractAbstract PDF
To estimate the cancer mortality rates among Koreans, a mortality survey was carried out in the province of Kyongsangnam-do. The study population are the beneficiaries of Korea Medical Insurance Corporation (KMIC), Kydngsangnam-do area, among which the 3,867 deaths occurred from January, 1989 to December, 1990, were reviewed to confirm the cancer deaths. These were based upon the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey was conducted along three steps. At first, the death certificates were examined, as a second step medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 990 deaths were found due to cancer. Using them, age and sex specific cancer(all sites and several sites) mortality rates were estimated. Overall cancer mortality rate in the area was estimated 138.7 per 100,000 person-years in males, and 65.7 in females, respectively. And the orders of site-specific cancer mortality rates were the cancers of stomach, liver, lung, esophagus, and cancers of the hematopoietic system among males, In females, followed by gastric cancer, cancers of lung and liver are the 2nd and 3rd in rank, respectively and cancers of breast and uterine cervix are the 4th and the 5th in rank.
Summary
A Response Pattern of Mailing Questionnaires.
Dae Hee Kang, Yoon Ok Ahn
Korean J Prev Med. 1988;21(2):451-453.
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AbstractAbstract PDF
No abstract available.
Summary
Seroepidemiology of Hepatitis B virus Infection in Healthy Korean Adults in Seoul.
Keun Young Yoo, Byung Joo Park, Yoon Ok Ahn
Korean J Prev Med. 1988;21(1):89-98.
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AbstractAbstract PDF
While there have been not a few reports on the seroepidemiological characteristics of hepatitis B virus (HBV) infection in Korea, most of them, however, have had several limitations; operational definition of HBV infection, validity of detection methods of HBV serologic markers, size of the study population, and confirmation of the vaccination history against HBV, etc. In order to avoid such limitations, authors randomly selected 1,495 healthy adults among the 217,511 insured (target population) of Korean Medical Insurance Corporation, living in seoul, and tested HBV(HBsAg, anti-HBs and anti-HBc) of all the subjects were tested, 392(26.2%) of interview failure cases 742 nonvaccinee were excluded from the actual population. Finally, the serologic markers tested of 742 nonvaccinee (study population) only were analyzed for the seroepidemiologic observation of the natural infection of HBV. The seroepidemiological characteristics of HBV infection in Korea were as follows ; 1 Point prevalence of HBs antigenemia was 11.7(9.1-14.3)% in male, which was slightly higher than that of female, 9.5(3.7-15.3)%. This level was one of the highest among those of Asian-Pacific countries. Decreasing tendency of HBsAg prevalence after the age of 50 was observed, which seems to be due to selective attrition of HBV chronic carriers among the healthy adults and/or to the limited-lasting duration of the HBs antigenemia, in part. 2. Point prevalence of anti-HBc(78.8% in male, 50.9% in female) was higher than that of anti-HBs(65.2% in male, 46.6% in female), respectively. And both of them were higher in male than in female. Increasing tendency of the prevalence of both antibodies was observed by age, which seems to be largely due to recurrent infection in adults and to some cumulative effect, in part, of their relatively longer-lasting duration. 3. The level of HBV infection defined by positive for at least one of the 3 serologic markers of HBV by RIA method was 84.7(81.8-87.6)% in male and 61.2(51.9-70.5)% in female, which was also one of the highest among those of Asian-Pacific countries. The proportion of susceptible population to HBV infection among healthy adults was 15.3% in male and 38.8% in female. 4. The relative frequency of current or past infection and chronic carrier among HBV infected person was estimated. The currently or past infected was estimated 75.7% in male and 71.8% in female, and chronic carrier state, 13.8% in male and 14.1% in female. The analysis of the geometric mean of the antibody titer in anti-HBs positive sera indicated also to be compatible with the above findings, suggesting that active, even though inapparent, infection of HBV occur so frequently among healthy adults in Korea.
Summary
An Epidemiological Study on the Neurological Sequelae of Acute Carbon Monoxide Poisoning.
Byung Joo Park, Soo Hun Cho, Yoon Ok Ahn, Young Soo Shin, Dork Ro Yun
Korean J Prev Med. 1984;17(1):5-24.
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AbstractAbstract PDF
There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% O2 group(38.0%). 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation and all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.
Summary
A Study on Development of Questionaire for Use in Epidmiologic Survey on Respiratory Illness in Korea.
Yoon Ok Ahn, Keun Youl Kim, E Hyock Kwon
Korean J Prev Med. 1982;15(1):57-74.
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Questionaires on symptoms of respiratory disease have been used in Korea to elicit the probable health effects of air pollution in epidemiologic studies. The objectives of such studies often include comparing prevalence of symptoms of respiratory system between different population groups or between the same population groups at different times. Unfortunately, little attention has been paid to standardization of those questionaires, whether those are Korean versions or not. Furthermore, no attempt to develop Korean questionaire on respirator symptoms and relevant information has been made. Followed by 'a comparative study on responses to Korean version questionaires (English origin) of CMI, MRC, and ATS-DLD-78' two types of questionaires on respiratory symptoms and relevant information for Korean adult, which are short form (SUN=81-AS) and long forms (optional questions are added to the short one, SUN-81-AL), have been designed suitable to Korean background by authors (see Annex). The self-administered and closed-question questionaire were tested their validity and reliability by administration to 180 normal adults(medical and nursing students) and 60 clinical patients of Seoul National University Hospital, with spirometric exam. The results obtained and conclusions drawn are as follow: 1. It took less than 10 minutes to complete the questionaire SNU-81-AS and SNU-81-AT. 2. The test-retest reliability of each questions in AS and AL were observed as 92.7% and 92.1%, respectively. And all of the level of agreement are statistically significant with kappa statistic. 3. In addition to higher prevalence rate of symptoms in patients group compared with normal group, the correlations between FEV 1.0/FVC predictive value(%) and number of symptoms were statistically significant in patients group (See Fig. 1 and Table 7). 4. The answer rate to optional questions in AL form among those who are not to do was about 10%, while the no-answer rate among who are to do was about 15% in Normal (medical and nursing students) group. 5. From the viewpoints of validity and reliability, the new Korean questionaire (SNU-81-AS and AL) developed by authors are to be recommendable to use in epidemiologic studies on respiratory illness in Korea. The self-administration, however, of opthional questions in AL form may not assure the quality of data gathered.
Summary
A Comparative Study on Responses to Korean Version Questionaires on Respiratory Symptoms.
Yoon Ok Ahn, Byung Joo Park, E Hyock Kwon
Korean J Prev Med. 1982;15(1):47-56.
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Korean versions of British Medical Research Council (MRC), Cornell 1V, Mgdical Index(CMI), and American Thoracic Society 78 (ATS-DLD-78) respiratory questionaires were compared with each other, and were tested the stability, in terms of test-retest reliability, of each questions by self-administration of those to 156 medical students. The results obtained and conclusions drawn are as follow: 1. The degree of agreements between responses to the comparable questions of CMI vs MRC, and of CMI vs ATS-DLD-78 were not satisfactory. There were, however, 71~100 per cent of agreement between responses to the questions on Cough, Wheezing, Phlegm, Breathlessness, and Chest illness of ATS-DLD-78 vs MRC questionaire. And the ATS-DLD-78 tended to yield greater number of positive responses than MRC (See Table 4). 2. All of the coefficient of stability of each questions in 3 questionaires were statistically significant, ranged 77~100 per cent, except that of the question on episode' of cough and phlegm in ATS-DLD-78 questionaire (See Table 5-1). The question is composed of two collateral conditions, "lasting for 3 weeks or more" and "each year". 3. It can be insisted that the Section-B questions of CMI is not proper for use in epidemiologic survey on respiratory illness. And rather than MRC, the ATS-DLD-78 questionaire deserves to prefer to be used in epidemiologic studies on respiratory illness. 4. In question-wording, especially, of inquiring past experience, it is possible to Iessen the reliability of the question that including collateral conditions such as 'the duration lasted of symptoms', and moreover, of which words are not common usage. For example, for Korean '10-days' or 'half a month' is more familiar time unit rather than 'week'.
Summary
Some Biologic Correlates of Perinatal Mortality.
Yoon Ok Ahn
Korean J Prev Med. 1976;9(1):129-138.
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No abstract available.
Summary
The Effect of an Oral Contraceptive (Eugynon) Upon Lactation.
E Hyock Kwon, Tae Ryong Kim, Kil Won Kang, Jae Woong Hong, Yoon Ok Ahn
Korean J Prev Med. 1975;8(1):15-24.
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There are a number of published reports aimed at clarifying the effect of hormonal contracept -ives upon the quantity and quality of breast milk during postpartum and lactation periods. As to the volume of milk produced by breast feeding mothers, many authors seem to have agreed on a decrease as an established pattern in the periods following regular administration of oral contraceptives containing estrogen in varying dosage. The quality of milk following administration of hormonal contraceptives, however, remsins a controversial issue. Korea's experience in oral contraceptive is rather a brief one, but use of Eugynon has been widespread and frequent since this hormonal contraceptive was introduced into the national program in 1967. The authors have reviewed the potential significance of data concerning regular use of an oral contraceptive as affecting lactation, and have sought to clarify the interrelationship between the administration of Eugynon and quantity and quality of breast milk from mothers contracepting. with Eugynon in different periods following confinement. A total of 85 women, who were at different periods following deliveries, have been divided into, two groups, one comprising 28 women regularly taking oral pills and the other (57 women) not resorting to hormonal contraceptives if they were contracepting at all. 1. Milk Volume. In view of the possible influence of suckling on the amount of milk produced, efforts were made in this study to standardize the technique by extracting breastmilk by applying manual pressures on one side of the maw-nae, While the nipple on the other side was being sucked by the mother's own baby. The effetct of an exogenic ovarian hormone on the quantity as well as quality of breastmilk is generally understood to be inapparent until the drug is administered to women whose milk secreting function has been normalized. ") In the present study, it was observed that the decrease in the ammount of milk obtained from mothers in the periods following the 4th cycle of oral contraceptives or thereafter has turned out to be statistically insignificant. This result conforms i.u the findings by Tubari and others. It is assumed that it takes at lest 2 to 3 cycles of use before mammary glands are functionally adjusted to the use of exogenic hormonal contraceptives. 2. Specific Gravity and Composition of Milk There was no noticeable change in the protein and chloride content following continuous administration of ore.l contraceptives, while meaningful changes were observed in fat (increase) and calcium (decrease up to the 5th cycle use) contents. Also, there was a rather significant decrease in the specific gravity in the period following administration of the first cycle of the oral contraceptive. The findings from the present study partially conforms the results published by Ramadan and others, who reported that little change was noticed in the contents of total solids. ash, chlorides and lactose in the breast milk of women who had taken 4 cycles of ovosiston, although in our study lactose was not measured. Ramaden, however, reported that fat content did increase in the same milk, as in our study. A definitive conclusion, however, could not be made unless measures are taken to rule out the physiological changes of the maternal body affecting the composition of milks.
Summary
Normal Range of Blood Pressure of Korean.
In Dal Kim, Yoon Ok Ahn, Soo Hun Cho
Korean J Prev Med. 1974;7(2):395-402.
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No abstract available.
Summary
Statistical Resumption for Health Articles in One Series of Medical Journals.
Yoon Ok Ahn, Ung Ring Ko
Korean J Prev Med. 1973;6(1):81-86.
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One hundred and thirty one health articles (as "original articles") reported in medical journals published in Korea during the period form Jan. to Dec. 1971. were selected as the study materials for the purpose of resumption and criticism. Of a total of 131 articles, thirty-nine were not required the statistical application for the data processing and drawing their conclusions and ninety-two, 70.2%, were needed to apply. The 92 articles were divided into three groups by the types of study: 54 for experimental study. 30 for clinical case analytic study and 8 for field study. Each report was resumed and criticised under the statistical aspects in terms of data processing and the validity of the conclusions. The results of resumption of the 92 articles needed statistical application are summarized as follow ; 1. Of the 54 articles of experimental studies resumed, thirty-one articles, 57.4% were considered acceptable. Among the 38 articles classified as clinical case analytic and field studies, only 28.9 per cent were considered acceptable. In total 45.7 per cent or less than half were considered acceptable. 2. Types of errors encountered are as shown in Table 3. 3. The most frequently encountered error was that the conclusions were drawn without having made any statistical test. This type of error was found in 14 out of 35 errors presented in experimental studies, 11 of 35 in clinical case analytic studies and 5 of 9 in field studies and 30 out of 97, 38.2%, in total.
Summary
JPMPH : Journal of Preventive Medicine and Public Health
© Korean Society for Preventive Medicine.