• The Journal of the Korean dental association
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• v.45 no.3 s.454
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• pp.169-181
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• 2007

In this second part of series report on evidence-based dentistry, the level of evidence and the methods for critical appraisal are discussed. The epidemiologic studies, namely clinical studies have some bias per se, and the degree of bias is somewhat predetermined by the study design. The level of evidence can be defined as the reliability of the clinical study and it is dependent on the degree of bias. Thus, it is important to determine the type of the study and to understand its structure before critically appraising them. Systematic reviews of primary studies, randomized controlled trials, nonrandomized clinical trials, cohort studies, case-control studies, and case reports / series constitute the clinical studies and the level of evidence follows the order of the studies listed above. Critical appraisal is the most important procedure in evidence-based dentistry. It is done to determine the credibility of research papers and their usefulness in the clinician s own practice. Critical appraisal is consisted of multiple questions that are helpful for evaluating validity and usefulness of the studies concerning therapy, diagnosis, prognosis, and causation.

• Korea journal of population studies
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• v.14 no.1
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• pp.55-69
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• 1991

The objective of the study is to figure out the status of reproductive health and general characteristics related to maternal health for Korean-Americans living in Los Angeles. We collected data from the married women who wanted no more additional child birth and were attending the Family Planning Clinic of Koryo Health Foundation in Los Angeles during 1988. There were 494 women met the eligibility requirement for this study. The results are summarized below. 1. In the age distribution of the women who desired no more additional child birth, women 30-34 age group constituted the largest proportion at 36.6 percent ; the mean age of women was 35.1915.55. The mean number of child birth was 1.77, and the proportion of the women by number of child birth were 35.2 percent for one children, 50.1 percent for two children 10.5 percent for three children, and 2.6 percent for four children. All of the women experienced pregnancy at least once, and mean number of pregnancy was 3.42. The mean number of total experience of induced abortion was 1.56. and 76.7 percent of these women had experience with induced abortions. To prevent further pregnancies, 90.1 percent of the women were utilizing the contraceptive methods, and the highest proportion by the contraceptive methods was condoms(53.7%), 9.3 percent in spermicides, 8.7 percent in IUDs, 8.7 percent in rhythm method, and 6.9 percent in oral pills. 2. The mean age of women at each stage of reproductive life cycle were 14.74 years at time of menarche, 24.55 years at time of marriage, 26.60 years at time of the first child birth, and 28.75 years at time of the last child birth. In age distribution of the women by birth cohort (Group I : birth cohort 1940-1954, Group H : birth cohort 1955-1970), the mean menar-cheal age of the women was 14.96 years in group I , and 14.53 years in group H . Mean age at time of marriage was 25.01 years in group I and 24.08 years in group H . Mean child birth age of the women by birth cohort was 27.19 years In group I and 26.01 years in Group II for the first child birth and 30.07 years in group I and 27.45 years in group II for the last child birth. The total length of reproductive life cycle from menarche to menopause (presumed to be at 49 of age years) was 34.26 years. The len-gth of phase I (from menarche to marriage) was 9.81 years, while phase H (marriage to first birth) was 2.05 years, and phase Ill (first birth to last birth) was 2. 15 years, and the last phase of reproductive life cycle, phase IV (last birth to menopause) was 20.25 years. The proportion of each phase 10 total length of reproductive life cycle was 28.6 percent, 6.0 percent 6.3 percent, and 59.t percent respectively. In the tendency of each phase in reproductive life cycle by birth cohort (group I , U ), the length of phase I, II , III of birth cohort group II was diminished in comparison with those of birth cohort group I , but the length of phase IV was extended by 2.38 years. 3. Among the women, the mean number of total pregnancy by birth cohort group was 2.01 in group I and 1.10 in Group II, and mean number of child birth was 1.97 in group I and 1.58 in group II. In terms of pregnancy was-tage rate by birth cohort group, among the total pregnancy of birth cohort group I , 51.8 percent of the cases resulted in induced abortions or spontaneous abortions whils 48.2 percent resulted in live births, and 42.2 percent or total pregnancy in group II resulted in pregnancy wastage and 57.8 percent of the cases resulted in live births.

• Safety and Health at Work
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• v.8 no.2
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• pp.130-142
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• 2017

Background: Osteoarthritis of the knee is considered to be related to knee straining activities at work. The objective of this review is to assess the exposure dose-response relation between kneeling or squatting, lifting, and climbing stairs at work, and knee osteoarthritis. Methods: We included cohort and case-control studies. For each study that reported enough data, we calculated the odds ratio (OR) per 5,000 hours of cumulative kneeling and per 100,000 kg of cumulative lifting. We pooled these incremental ORs in a random effects meta-analysis. Results: We included 15 studies (2 cohort and 13 case-control studies) of which nine assessed risks in more than two exposure categories. We considered all but one study at high risk of bias. The incremental OR per 5,000 hours of kneeling was 1.26 (95% confidence interval 1.17-1.35, 5 studies, moderate quality evidence) for a log-linear exposure dose-response model. For lifting, there was no exposure dose-response per 100,000 kg of lifetime lifting (OR 1.00, 95% confidence interval 1.00-1.01). For climbing, an exposure dose-response could not be calculated. Conclusion: There is moderate quality evidence that longer cumulative exposure to kneeling or squatting at work leads to a higher risk of osteoarthritis of the knee. For other exposure, there was no exposure dose-response or there were insufficient data to establish this. More reliable exposure measurements would increase the quality of the evidence.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.321-333
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• 2022

Objectives: Extensive evidence links low vitamin D status and comorbidities with coronavirus disease 2019 (COVID-19) outcomes, but the results of published studies are contradictory. Therefore, we investigated the association of lower levels of vitamin D and comorbidities with the risk of COVID-19 infection. Methods: We searched MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for articles published until August 20, 2021. Sixteen eligible studies were identified (386 631 patients, of whom 181 114 were male). We included observational cohort and case-control studies that evaluated serum levels of vitamin D in COVID-19-positive and COVID-19-negative patients. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Results: Significantly lower vitamin D levels were found in COVID-19-positive patients (MD, -1.70; 95% CI, -2.74 to -0.66; p=0.001), but with variation by study design (case-control: -4.04; 95% CI, -5.98 to -2.10; p<0.001; cohort: -0.39; 95% CI, -1.62 to 0.84; p=0.538). This relationship was more prominent in female patients (MD, -2.18; 95% CI, -4.08 to -0.28; p=0.024) than in male patients (MD, -1.74; 95% CI, -3.79 to 0.31; p=0.096). Male patients showed higher odds of having low vitamin D levels (odds ratio [OR], 2.09; 95% CI, 1.38 to 3.17; p<0.001) than female patients (OR, 1.17; 95% CI, 0.74 to 1.86; p=0.477). Comorbidities showed inconsistent, but generally nonsignificant, associations with COVID-19 infection. Conclusions: Low serum vitamin-D levels were significantly associated with the risk of COVID-19 infection. This relationship was stronger in female than in male COVID-19 patients. Limited evidence was found for the relationships between comorbidities and COVID-19 infection, warranting large population-based studies to clarify these associations.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.101-110
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• 2022

There is a considerable number of individuals who exhibit features of both asthma and chronic obstructive pulmonary disease (COPD), defined as asthma-COPD overlap (ACO). Many studies have reported that these patients have a greater burden of symptoms, including cough and dyspnea, and experience more exacerbations and hospitalizations than those with non-ACO COPD or asthma. Although diagnostic criteria for ACO have not yet been clearly established, their clinical significance remains to be determined. As interest in ACO grows, related studies have been conducted in South Korea as well. The present review summarizes ACO-related studies in South Korea to better understand Korean ACO patients and guide further research. Several cohort studies of asthma and COPD and population-based studies for ACO were reviewed and the key results from demographics, clinical features, lung function, biomarkers, treatment, and prognosis were summarized.

• Journal of Preventive Medicine and Public Health
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• v.40 no.1
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• pp.23-28
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• 2007

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

• Korea journal of population studies
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• v.25 no.2
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• pp.163-192
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• 2002

Residential overcrowding, also called density, measured as more than one person per room, is a important variable as a principal indicator of inadequate housing. We investigated how immigrants in the US are assimilated to the host society through a lens of housing density. We estimated the probability of living in overcrowded housing of Korean, Chinese and Japanese immigrants armored with the 1980 and 1990 Public Use Microdata Sample(PUMS, A, 5%) in the US. Along with economic effects, we also consider life-cycle effects on the indicator. We applied "double cohort" method that enables duration of immigration effects to be separated from aging effects, which captures family size fluctuations due to life-cycle effects. The study found that cohort trends sharply changed during 10years. The 1970's immigrants are more likely to live in overcrowded housing than the pre-1970 immigrants. The pre-1970 immigrants are more likely to live in overcrowded housing than native-born persons. This may be explained by different assimilation processes driven by the disparities of individual human capitals or cultural differences among the ethnic groups. Especially, Korean experienced a sharp decline in overcrowding between 1980 and 1990. We also found that the major determinants that affect the level of housing density are years since migration, income, and gender. The present study concluded with some future studies related to the Korean immigrants abroad.ts abroad.

• Korean Journal of Social Welfare Studies
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• v.41 no.3
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• pp.349-378
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• 2010

The Life-Course perspective is a theoretical orientation that views the life-course as the age structure embedded in social institutions and history and understands the life-course of individual and group in the contextual perspective. The life-course perspective studies were developed in Germany and North America. They study social and historical effects and the effect of institutions and the state on the life-course, the pathway of the work career and differences of labour outcomes, and the inequality that is developed in the life-course. In Korea, the life-course perspective studies were tried in various fields and cumulated. However, it didn't established as a theoretical orientation. For applying the life-course perspective to connect the individual life-course with social and historical event, I describe the historical location of individuals born between 1930 and 1979 and analyse the change of their transitions to adulthood exploratorily. On results, the extension of education made the structural change of their life-course, and in young cohort the timing of leaving school, entering workforce, marriage and childbirth was delayed and transitions were made in narrower spread. It means the standardization of the life-course as appears in modern society. The 1970s birth cohort has the differenciated life-course pattern, however I cannot verify that change because of the right censoring.

• The Journal of the Korean dental association
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• v.51 no.9
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• pp.494-500
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• 2013

Recently, several researches indicated the relationship between oral condition and respiratory disease such as pneumonia and chronic obstructive pulmonary disease (COPD). Respiratory disease is known as common chronic disease in the elderly increasing mortality and morbidity. In this study, we have reviewed the association between oral disease and respiratory disease in the elderly. The related data were searched and collected from abroad and domestic studies. The studies included the randomized controlled clinical trials (RCTs), longitudinal, cohort, case-control, and systematic review studies. With the data from the studies, we concluded that poor oral hygiene or periodontal disease can influence the pneumonia in the elderly. Further studies will be needed to investigate the association between oral disease and COPD.

• Safety and Health at Work
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• v.9 no.3
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• pp.249-256
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• 2018

This article aims to provide a systematic review of the exposure assessment methods used to assign wafer fabrication (fab) workers in epidemiologic cohort studies of mortality from all causes and various cancers. Epidemiologic and exposure-assessment studies of silicon wafer fab operations in the semiconductor industry were collected through an extensive literature review of articles reported until 2017. The studies found various outcomes possibly linked to fab operations, but a clear association with the chemicals in the process was not found, possibly because of exposure assessment methodology. No study used a tiered assessment approach to identify similar exposure groups that incorporated manufacturing era, facility, fab environment, operation, job and level of exposure to individual hazardous agents. Further epidemiologic studies of fab workers are warranted with more refined exposure assessment methods incorporating both operation and job title and hazardous agents to examine the associations with cancer risk or mortality.