• Title/Summary/Keyword: Cohort Study

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Dioxins and Health: Human Exposure Level and Epidemiologic Evidences of Health Effects (다이옥신과 건강: 인체 노출 수준 및 건강영향에 대한 역학적 연구)

  • Jang, Jae-Yeon;Kwon, Ho-Jang
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.303-313
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    • 2003
  • General information is summarized, that is necessary to introduce a scientific assessment of the human health and exposure issue concerning dioxin and dioxin-like compound. Scientific literatures were reviewed to assess the background exposures to the dioxin-like compounds for normal residents. Epidemiologic studies were also reviewed to assess malignant and nonmalignant sweets of dioxins. In 1997, the International Agency for Research on Cancer classified 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as a human carcinogen, primarily based on occupational cohort studies. The US Environmental Protection Agency made the same decision in it's Draft Dioxin Reassessment. Epidemiologic evidences point to a generalized excess of all cancers, without any pronounced excess at specific sites. Reported non-cancer effects included a range of conditions affecting most systems. Among them, chloracne, elevation in gamma glutamyl transferase(GGT), and alterations in reproductive hormones are related to TCDO, Other adverse outcomes, such as lipid concentrations, diabetes, circulatory and heart diseases, immunologic disorders, neurobehavioral effects, and developmental outcomes require further study before their respective relationships to TCDD can be more definitively assessed.

Secular change of physical growth in Korean children and youth between 1999 and 2005 (아동 및 청소년 신체발육의 단기적 시대변화)

  • Kim, Myung;Kim, Hye-Kyeong;Matsuura, Yoshiyuki
    • Korean Journal of Health Education and Promotion
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    • v.24 no.5
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    • pp.69-85
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    • 2007
  • Purpose: The purpose of this study is to clarify the traits of differences supposed as secular differences in physical growth between samples of children and youth in 1999 and 2005, and to identify the need of children and youth for health promotion. Methods: Two samples of different cohort were selected. The first one was consisted of 231 boys and 346 girls in 1999. And the other was consisted of 171 boys and 400 girls in 2005. Then the longitudinal growth distance data were collected from their cumulative health examination records. Results: The 2005 were larger in growth distances of stature, body weight, sitting height, and chest girth a at all ages from 6 to 16 in both boys and girls, so it could be concluded that a certain positive shift in growth process appeared in such a short duration. The 2005 were larger in growth velocity before peak age and also after peak age in body weight, but only in the term after peak age significant secular differences were found in stature for both sexes. As far as the growth distance concerned, the 2005 boys were ahead of the 1999 boys from 0.28-1.02 years and the 2005 girls from 0.32 to 0.81 years. In growth distance. Only in peak velocity, significant secular change was recognized in both sexes, any positive evidences of appearance of secular change were not found in peal age. In such derived physical indices as BMI, body weight index, sitting height index, and chest girth index, obvious evidences of secular change appearance were found.

Body Composition as a Prognostic Factor of Neoadjuvant Chemotherapy Toxicity and Outcome in Patients with Locally Advanced Gastric Cancer

  • Palmela, Carolina;Velho, Sonia;Agostinho, Lisa;Branco, Francisco;Santos, Marta;Santos, Maria Pia Costa;Oliveira, Maria Helena;Strecht, Joao;Maio, Rui;Cravo, Marilia;Baracos, Vickie E.
    • Journal of Gastric Cancer
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    • v.17 no.1
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    • pp.74-87
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    • 2017
  • Purpose: Neoadjuvant chemotherapy has been shown to improve survival in locally advanced gastric cancer, but it is associated with significant toxicity. Sarcopenia and sarcopenic obesity have been studied in several types of cancers and have been reported to be associated with higher chemotherapy toxicity and morbi-mortality. The aim of this study was to assess the prevalence of sarcopenia/sarcopenic obesity in patients with gastric cancer, as well as its association with chemotherapy toxicity and long-term outcomes. Materials and Methods: A retrospective analysis was performed using an academic cancer center patient cohort diagnosed with locally advanced gastric cancer between January 2012 and December 2014 and treated with neoadjuvant chemotherapy. We analyzed body composition (skeletal muscle and visceral fat index) in axial computed tomography images. Results: A total of 48 patients met the inclusion criteria. The mean age was $68{\pm}10years$, and 33 patients (69%) were men. Dose-limiting toxicity was observed in 22 patients (46%), and treatment was terminated early owing to toxicity in 17 patients (35%). Median follow-up was 17 months. Sarcopenia and sarcopenic obesity were found at diagnosis in 23% and 10% of patients, respectively. We observed an association between termination of chemotherapy and both sarcopenia (P=0.069) and sarcopenic obesity (P=0.004). On multivariate analysis, the odds of treatment termination were higher in patients with sarcopenia (odds ratio=4.23; P=0.050). Patients with sarcopenic obesity showed lower overall survival (median survival of 6 months [95% confidence interval {CI}=3.9-8.5] vs. 25 months [95% CI=20.2-38.2]; log-rank test P=0.000). Conclusions: Sarcopenia and sarcopenic obesity were associated with early termination of neoadjuvant chemotherapy in patients with gastric cancer; additionally, sarcopenic obesity was associated with poor survival.

Effects of Tomatoes and Lycopene on Prostate Cancer Prevention and Treatment (토마토와 라이코펜이 전립선암의 예방과 치료에 미치는 영향)

  • ;Phyllis E. Bowen
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.2
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    • pp.455-462
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    • 2004
  • Prostate cancer is a leading cause of cancer death in American men and evidences point to significant life style/diet components as risk factors for its development or prevention. Two large cohort studies have identified the consumption of tomatoes or high Plasma levels of Iycopene as associated with reduced risk. A number of other substances such as quercetin, phytoene, phytofluene, cyclolycopene, salicylates and tomatine in tomato besides lycopene could have anticancer activity and may be acting synergistically with lycopene. Lycopene at almost physiologically feasible concentrations, reduces cell viability by cell cycle arrest and apoptosis and modulates the cyclin pathways as well as increasing intercellular communication. However, it is not clear whether lycopene or its oxidation products are more bioactive. Tomato product supplementation results in plasma accumulation of phytoene, Phytofluene, the lycopene oxidation product, and cyclolycopene at significant concentrations and lycopene supplementation, either as a tomato product or as beadlets, results in maximal mean plasma lycopene concentrations of ∼ 1 $\mu$M which is at the lower limit of its activity in cell culture. Rats and mice are poor accumulators of lycopene and other carotenoids making them poor models for the study of cancer prevention and control. Of the 19 animal studies for various cancer sites, lycopene showed a positive effect in 10 studies but negative in 2 prostate cancer studies. In vivo prevention of leukocyte DNA damage in humans has been mostly studied using tomato product supplementation but lycopene supplementation appeared to reduce oxidative DNA damage as well as tomato product supplementation. Lycopene appears to be bioactive in intefering with carcinogenesis but the actions of phytoene, phytofluene or cyclolycopene cannot be ruled out since these compounds were present in most of the lycopene material used for these studies. Although lycopene remains as a promising agent, especially for cancer control, exploring interactions with other tomato phytochemicals and with current prostate cancer therapies should be encouraged.

Duration of Pulmonary Tuberculosis Infectiousness under Adequate Therapy, as Assessed Using Induced Sputum Samples

  • Ko, Yousang;Shin, Jeong Hwan;Lee, Hyun-Kyung;Lee, Young Seok;Lee, Suh-Young;Park, So Young;Mo, Eun-Kyung;Kim, Changhwan;Park, Yong Bum
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.1
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    • pp.27-34
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    • 2017
  • Background: A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non-drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens. Methods: We evaluated the duration of infectiousness of PTB using a retrospective cohort design. Results: Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0-42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5-28.0 days). Conclusion: The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB.

The Use of Inappropriate Antibiotics in Patients Admitted to Intensive Care Units with Nursing Home-Acquired Pneumonia at a Korean Teaching Hospital

  • Kim, Deok Hee;Kim, Ha Jeong;Koo, Hae-Won;Bae, Won;Park, So-Hee;Koo, Hyeon-Kyoung;Park, Hye Kyeong;Lee, Sung-Soon;Kang, Hyung Koo
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.1
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    • pp.81-88
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    • 2020
  • Background: Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home-acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Methods: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015-May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression. Results: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics-treated group than in the appropriate antibiotics-treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER. Conclusion: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.

Prevalence of Trichomonas vaginalis by PCR in Men Attending a Primary Care Urology Clinic in South Korea

  • Seo, Jun-Hyeok;Yang, Hye-Won;Joo, So-Young;Song, Su-Min;Lee, Yu-Ran;Ryu, Jae-Sook;Yoo, Eun Sang;Lee, Won Kee;Kong, Hyun-Hee;Lee, Sang-Eun;Lee, Won-Ja;Goo, Youn-Kyoung;Chung, Dong-Il;Hong, Yeonchul
    • Parasites, Hosts and Diseases
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    • v.52 no.5
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    • pp.551-555
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    • 2014
  • Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic non-gonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.

Prevalence of Viruses with Diarrhea among Hospitalized Children West Gyeonggi Province (경기서부지역 설사 환아의 바이러스 유병율)

  • Seo, Soo Young;Jung, In Ah;Kim, Ji Hoon;Cho, Kyung Soon;Bin, Joong Hyun;Kim, Hyun Hee;Lee, Hee Jin;Lee, Wonbae
    • Pediatric Infection and Vaccine
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    • v.19 no.1
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    • pp.28-36
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    • 2012
  • Purpose : This study was conducted to evaluate epidemiological data of the viral pathogens obtained from stool exams and provide information on the regional prevalence of infectious diarrheal disease west in Gyeonggi Province, Korea. Methods : We enrolled a cohort of children <10 years of age admitted for treatment of acute diarrhea at Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea. In total, 310 fecal specimens, documented to be free of common bacterial pathogens, were collected from pediatric patients during a 12-month period from January to December 2009 and were tested for the presence of rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, and norovirus using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) assay. Results : The most common virus was parechovirus (16%), followed by adenovirus (15%), astrovirus (14%), rotavirus (13%), and enterovirus (5%). Interestingly, only one of the specimens was positive for norovirus. Single infection cases were detected in 173 (55.8%) of the 310 children, whereas mixed viral infections were detected in 10 (3.2%) of the same children. Viral gastroenteritis generally showed a double peak of incidence. Parechovirus, rotavirus, and adenovirus shared a similar pattern of peak incidence with overall viruses; however, astrovirus infections occurred more frequently in the spring. Eighty-five percent of the confirmed viral gastroenteritis cases developed in under 24 months. Conclusion : The results support the importance of parechovirus, adenovirus, astrovirus, and enterovirus as causative agents of diarrhea in children, which may be underestimated by current routine diagnostic testing.

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Association of Anthropometric Indices with Prevalence of Hypertension in Korean Adult (일부 지역 주민에서 고혈압이환과 비만지표와의 관련성)

  • Son, Lack-Seong;Yoon, Tai-Young;Choi, Joong-Myung;Park, Soon-Young;Lew, Dong-Joon;Choe, Bong-Keun
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.443-451
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    • 1999
  • Objective: To examine the relationship between hypertension prevalence and the four commonest anthropometric measurements for obesity(body mass index(BMI), wasit-hip ratio(WHR), waist circumference(WC) and body fat in Korean adults. Methods: We studied the cross-sectional association of the anthropometric indices and blood pressure in 1,197 individuals(who were participants in the population-based cohort study). Hypertension was defined as blood pressure $\geq160/95\;mmHg$ or current use of antihypertensive medication. Informations on life-style factors were obtained from personal interview. Results: There were close associations between BMI, WHR and WC with blood pressure in both men and women. After age adjustment, BMI and WC showed significantly positive correlation with systolic and diastolic blood pressure levels in both men and women. Odds ratio(ORs) of being hypertensive were estimated comparing the highest to the lowest quantile, adjusting for age, smoking status, alcohol intake levels, education attainment. The simultaneously adjusted ORs of being hypertensive, comparing the highest vs the lowest categories, was for BMI 2.0(95% confidence interval(CI)=0.9-3.2) in men and 3.2 (95% CI=1.7-6.1) in women, for WC 2.1(95% CI=1.0-4.4) in men and 3.1 (95% CI=1.6-5.9) in women, for fat(%) 4.2(95% CI=1.9-9.5) in men and 2.1(95% CI=1.2-3.6) in women. Conclusion: In addition to measures of overall obesity(BMI) as well as central obesity(WHR, WC), body fat(%) was independently associated with prevalence of hypertension. Among obesity indices, body fat was the most predictor variable in hypertensive state in male and BMI was in female.

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Medical Expenditure Attributable to Overweight and Obesity in Adults with Hypertension, Diabetes and Dyslipidemia : Evidence from Korea National Health and Nutrition Examination Survey Data and Korea National Health Corporation Data (성인의 고혈압, 당뇨병, 이상지질혈증으로 인한 총 진료비 중 과체중 및 비만의 기여분 : 국민건강영양조사자료와 국민건강보험공단 자료를 중심으로)

  • Kang, Jae-Heon;Jeong, Baek-Geun;Cho, Young-Gyu;Song, Hye-Ryoung;Kim, Kyung-A
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.77-88
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    • 2010
  • Objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with hypertension, diabetes and dyslipidemia using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. Methods: The medical expenditure of hypertension, diabetes and dyslipidemia related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. Results: The medical expenditure attributable to overweight and obesity of hypertension were 456 billion won (men : 215 billion won, women : 241 billion won). Those of diabetes were 282 billion won (men : 148 billion won, women : 135 billion won), and of dyslipidemia were 17 billion won (men : 9 billion won, women : 8 billion won). Consequently, these costs corresponded to 33.3% of total medical expenditure due to hypertension, diabetes and dyslipidemia. Conclusions: We found a substantial medical expenditure due to overweight and obesity of hypertension, diabetes and dyslipidemia were very high. In order to reduce these costs, effective national strategies for prevention and management of overweight and obesity should be established and implemented.