• Health Policy and Management
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• v.26 no.1
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• pp.12-23
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• 2016

Background: Many studies have explained regional disparities in health by socioeconomic status and healthcare resources, focusing on differences between urban and rural area. However some cities in Korea have the highest cardiovascular mortality, even though they have sufficient healthcare resources. So this study aims to confirm three hypotheses. (1) There are also regional health disparities between cities not only between urban and rural area. (2) It has different regional risk factors affecting cardiovascular mortality whether it is urban or rural area. (3) Besides socioeconomic and healthcare resources factors, there are remnant factors that affect regional cardiovascular mortality such as health behavior and physical environment. Methods: The subject of this study is 227 local authorities (si, gun, and gu). They were categorized into city (gu and si consisting of urban area) and non-city (gun consisting of rural area), and the city group was subdivided into 3 parts to reflect relative different city status: city 1 (Seoul, Gyeonggi cities), city 2 (Gwangyeoksi cities), and city 3 (other cities). We compared their mortalities among four groups by using analysis of variance analysis. And we explored what had contributed to it in whole authorities, city and non-city group by using multiple regression analysis. Results: Cardiovascular mortality is highest in city 2 group, lowest in city 1 group and middle in non-city group. Socioeconomic status and current smoking significantly increase mortality regardless of group. Other than those things, in city, there are some factors associated with cardiovascular mortality: walking practice(-), weight control attempt(-), deficiency of sports facilities(+), and high rate of factory lot(+). In non-city, there are other factors different from those of city: obesity prevalence(+), self-perceiving obesity(-), number of public health institutions(-), and road ratio(-). Conclusion: To reduce cardiovascular mortality and it's regional disparities, we need to consider differentiated approach, respecting regional character and different risk factors. Also, it is crucial to strengthen local government's capacity for practicing community health policy.

• Research in Community and Public Health Nursing
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• v.17 no.1
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• pp.112-124
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• 2006

Purpose: This study was carried out to investigate the relationships among suicidal risk, self-esteem, and spiritual well-being of high school students, and to provide basic data for developing suicide prevention programs. Method: The subjects of this study were 1.176 high school students from six academic high schools and two technical high schools in Daegu City. Data were collected from the 13th to the 25th of September 2004. The research tools were the Suicide Probability Scale developed by Go. Kim and Lee (2000), the Self-Esteem Inventory modified by Choi and Jeon (1993), and the tool of Spiritual Well-Being modified by Yoo (2002). Data were analyzed with SPSS Windows 11.0. Result: Variables that showed statistically significant difference in suicidal risk were school type, whether to have the best friends, the number of close friends, current relationship with close friends, experience of school violation, respect for the teacher, grades, financial condition, parents marital status, father's education level, mother's education level, home atmosphere, conversation with father, conversation with mother, smoking, drinking, experience of counseling for problems, whether to have physical illnesses, experience of thinking about suicide, experience of attempting suicide. Suicidal risk was in a significantly negative correlation with self-esteem and spiritual well-being. Conclusion: The researcher identified many different variables that affect the suicidal risk of high school students. Self-esteem and spiritual well-being were found to be in a significant correlation with suicidal risk. Therefore, the results of this study can be used as basic data and information for suicidal prevention programs.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.11-22
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• 2015

Objectives: This study was to examine the influences of community characteristics on the mortality rates. Community characteristics included socioeconomic environmental characteristics, health care resources, and health lifestyle practice. Methods: This study used secondary data whose units of analyses were 249 administrative districts. Mortality rates were estimated with hierarchical regression models entered in the order of (1) socioeconomic environmental characteristics, (2) health care resources, and (3) health lifestyle practice. Results: About 70% of mortality rate was explained by socioeconomic environmental characteristics, health care resources, and health lifestyle practice. In particular, socioeconomic environmental characteristics showed the strongest impact on mortality rate. Among socioeconomic characteristics, community with lower rate of households headed with college or more, lower number of inhabitants per on-premise license, higher rate of population in poverty, and rural region showed higher mortality rate. Among health care resources, community with higher number of inhabitants per doctor and lower number of inhabitants per hospital bed showed higher mortality rate. Among health lifestyle practice, community with higher current smoking rate and lower moderate physical activity practice rate showed higher mortality rate. Conclusions: The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5899-5902
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• 2015

Background: To compare the current histologic distribution of lung cancer in Lebanon to the worldwide trends, according to the 2004 WHO Classification. Materials and Methods: 1,760 patients with a pulmonary pathology examination at Hotel-Dieu de France University Hospital between July 2009 and July 2014 were included. Results: Some 676 out of the total investigated patients (38.4%) had a lung tumor. In 665 (98.4%) the tumors were malignant, with a mean age at diagnosis of 63.8 years and a male/female (M/F) sex ratio of 1.7:1. Among the malignant tumors, 86.2% were epithelial tumors with a mean age at diagnosis of 64.8 years and an M/F sex ratio of 1.9. Other malignant tumors consisted of metastatic tumors (10.2%), lymphoproliferative tumors (2.1%) and mesenchymal tumors (1.5%). Most common carcinoma subtypes were adenocarcinoma (48.0%), squamous cell carcinoma (23.0%) and small cell carcinoma (13.3%). Carcinoid tumors were the only carcinoma subtype with an M/F sex ratio below 1 (0.7). Salivary gland tumors were the carcinoma with lowest mean age at diagnosis (45.5 years). Conclusions: The histologic distribution of lung tumors in Lebanon is similar to that in developed countries. We believe this resemblance is due to common smoking habits, known to be responsible for the increase of lung adenocarcinoma at the expense of other subtypes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3253-3260
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• 2014

Background: A case-control study was conducted to evaluate the effect of household exposure, dietary habits, smoking and Glutathione S-Transferases M1, T1 polymorphisms on lung cancer among women in Mizoram, India. Materials and Methods: We selected 230 newly diagnosed primary lung cases and 460 controls from women in Mizoram. Multivariate logistic regression analysis was performed to estimate adjusted odds ratio (OR). Results: Exposure of cooking oil fumes (p<0.003), wood as heating source for cooking (p=0.004), kitchen inside living room (p=0.001), improper ventilated house (p=0.003), roasting of soda in kitchen (p=0.001), current smokers of tobacco (p=0.043), intake of smoked fish (p=0.006), smoked meat (p=0.001), Soda (p<0.001) and GSTM1 null genotype (p=0.003) were significantly associated with increased risk of lung cancer among women in Mizoram. Significantly protective effect was observed for intake of bamboo shoots (p=<0.001) and egg (p<0.001). A clear increase in dose response gradient was observed for total cooking dish years. Risk for lung cancer tends to increase with collegial effect of indoor environmental sources (p=0.022). Significant correlation was also observed for interaction of GST polymorphisms with some of dietary habits. Conclusions: We confirmed the important role of exposure of cooking oil emission and wood smoke, intake of smoked meat, smoked fish and soda (an alkali preparation used as food additives in Mizoram) and tobacco consumption for increase risk of lung cancer among Women in Mizoram.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.941-944
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• 2012

Objective: The aim of current study was to evaluate the changes of health-related quality of life (HRQoL) and its clinical, demographic and socioeconomic determinants during chemotherapy and 4 months follow-up in women with breast cancer using a repeated measures framework. Methods and Materials: A double blind cohort study was performed in 100 breast cancer patients given fluorouracil, doxorubicin and cyclophosphamide (FAC) or docetaxel, doxorubicin, cyclophosphamide (TAC) in south of Iran. HRQoL was assessed at baseline, end of chemotherapy and four months thereafter using the QLQ-C30 questionnaire from European Organization for Research and Treatment of Cancer (EORTC). Generalized estimating equations (GEE) was applied for statistical analysis. Results: The mean of age at baseline was $48.5{\pm}10.6$. 70% and 14% of patients were married and smokers, respectively, and 20% suffered from another disease besides breast cancer. The results of GEE showed that after control for baseline scores, the HRQoL significantly improved over time. Although, the patients in FAC group had higher scores than the TAC group, the differences also diminished over time. Smoking, marital status and having child affected some scales of HRQoL. None of other variables were significantly related to HRQoL. Conclusion: Although patients in TAC groups had lower level of HRQoL over 8 months follow up, they experienced faster improvement than the FAC group. This implies that in long-term, improvements in TAC group are higher than FAC. Having children was positively correlated with HRQoL. Generally, there were no demographic and socio-economic differences in HRQoL in these patients between the chemotherapeutic regimens.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5037-5041
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• 2013

Accumulated evidence has indicated that Ephrin A1 (EFNA1) is associated with angiogenesis and tumorigenesis in various types of malignancies, including colorectal cancer (CRC). In the current study, we performed an online search using the public microarray database to investigate whether EFNA1 expression might be altered in CRC tissues. We then conducted a case-control study including 306 subjects (102 cases and 204 well-matched controls) in Xiaoshan County to assess any association between genetic polymorphisms in EFNA1 and CRC susceptibility. Searches in the Oncomine expression profiling database revealed EFNA1 to be overexpressed in CRC tissue compared with adjacent normal tissue. The rs12904 G-A variant located in the 3' untranslated region (UTR) of EFNA1 was observed to be associated with CRC susceptibility. Compared with the AA homozygous genotype, those carrying GA genotype had a decreased risk of developing CRC (odds ratio (OR)=0.469, 95% confidence interval (CI): 0.225-0.977, and P=0.043). The association was stronger among smokers and tea drinkers, however, no statistical evidence of interaction between rs12904 polymorphism and smoking or tea drinking on CRC risk was found. Our results suggest that EFNA1 is involved in colorectal tumorigenesis, and rs12904 A>G polymorphism in the 3' UTR of EFNA1 is associated with CRC susceptibility. Larger studies and further mechanistic investigations are warranted to confirm our findings.

• Journal of Preventive Medicine and Public Health
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• v.28 no.1 s.49
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• pp.1-12
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• 1995

Diatomaceous earth, quarried from the remains of aquatic plants deposited millions of years ago, continues to be a very important raw material with many industrial uses. In its natural state, diatomaceous earth is an amorphous silica with no crystalline pattern. For many uses, however, it is calcinated and calcination converts a portion of the amorphous silica to a crystalline form, cristobalite which is far more fibrogenic. In a factory which produces calcinated diatomaceous earth, seven workers were proved as pneumoconiosis on 1991 and 1992. Authors reviewed medical chart and current status of them. Authors also examined thirty one subjects from the factory with questionnaire, physical examination, spirometry and chest radiography on August 13th 1993. The radiographs were independently interpreted by two radiologists and their findings were classified by International Classification of Radiography of Pneumoconiosis(ILO, 1980). Total and respirable dust of diatomaceous earth were measured on October 1993. The results were as follows; 1. Of 31 workers, 6 (19.4%) were diagnosed as diatomaceous earth pneumoconiosis. There was an increasing tendency in prevalence of pneumoconiosis as the duration of dust exposure gets longer. 2. There were no significant differences in age, smoking rate, alcohol drinking rate, and pulmonary function test results between cases and non-cases. 3. The means of total dust exposures at flour manufacturing, fire brick grinding and packaging, ceramic raws packaging processes exceeded Korean and ACGIH standards, $10mg/m^3$. Above results suggest that engineering controls, periodic environmental and medical surveillance are important for preventing pneumoconiosis in the diatomite factory.

• Journal of Preventive Medicine and Public Health
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• v.40 no.5
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• pp.411-417
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• 2007

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

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.477-481
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• 2017

We report a case of a 51 years old female with a 25 pack year smoking history who underwent bilateral mastectomy and immediate tissue expander reconstruction for newly diagnosed right breast cancer. The patient reported herself as a non-smoker despite significant e-cigarette use, with resulting significant mastectomy skin flap necrosis and breast reconstruction failure. Little is known about the physiologic effect of e-cigarettes on wound healing and tissue perfusion. To this end, we provide an updated review of the impact of e-cigarettes on surgical outcomes. PubMed, Ovid MEDLINE, and PRS GO were searched for the terms "e-cigarette", "electronic cigarette", "e-cig", "electronic nicotine delivery system", "vaping", "surgery", "surgical", "peri-operative", "operate", "operative", and "wound healing". Abstract review of all articles was performed. 123 articles returned that contained both variants of e-cigarettes and surgery as keywords. Of those, manual assessment returned three articles which were found to be relevant to e-cigarette use in the surgical patient. No articles were found that compared perioperative complications in e-cigarette versus traditional cigarette users in humans. In conclusion, our case report depicts the potential dangers associated with e-cigarette use in the surgical patient. There is a public misconception that e-cigarettes are healthier than traditional cigarettes and as such their use may go unreported by patients. Early evidence suggests e-cigarettes may induce some of the same physiologic changes as traditional cigarettes, and may have a significant deleterious effect on wound healing.