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Risk Reduction of Breast Cancer by Childbirth, Breastfeeding, and Their Interaction in Korean Women: Heterogeneous Effects Across Menopausal Status, Hormone Receptor Status, and Pathological Subtypes

  • Jeong, Seok Hun;An, Yoonsuk;Choi, Ji-Yeob;Park, Boyoung;Kang, Daehee;Lee, Min Hyuk;Han, Wonshik;Noh, Dong-Young;Yoo, Keun-Young;Park, Sue K.
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.6
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    • pp.401-410
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    • 2017
  • Objectives: The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype. Methods: BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs). Results: BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ${\geq}13$ months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58). Conclusions: This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ${\geq}13$ months can reduce their BC risk by about 50%.

Influence of Positional Changes of Arms and Legs to Electrocardiogram

  • Song, Joo-Eun;Song, Min-Ju;Kim, Ye-Sul;Yang, Ha-Nuel;Lee, Ye-Jin;Jung, Dongju
    • Biomedical Science Letters
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    • v.24 no.1
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    • pp.43-49
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    • 2018
  • Electrocardiogram (ECG) is a widely used method to diagnose electrical activity of heart. Although it is a reliable and easy method, ECG could be interfered by electrical signals. One of the interfering signals is electromyogram (EMG) that is caused by muscle contraction in any parts of the body except heart. To avoid the EMG noise, an examinee is advised to be relaxed on supine position while measuring ECG. Sometimes, patients who can't put their arms and legs down on bed due to some reasons such as cast on arms or legs necessarily have the EMG noise. But detailed information about how much of the noise could be induced by positional change of arms and legs has not been reported. Here we examined the noise by analyzing ECG data from 14 candidates, 7 males and 7 females. The ECG data was obtained using the standard 12 lead ECG. EMG noise was induced by raising arms and legs at $90^{\circ}$, $60^{\circ}$ or $30^{\circ}$. Because arms are located close to the heart, noise by the raised arms was analyzed toward left or right arm separately. All of the examinees showed similar pattern of the EMG noise. EMG noise by positional change of left or right arm was clearly monitored in different limb leads. Change of leg positions induced the noise that was monitored in aVF of augmented leads and II and III of limb leads. There was a difference in degree of the noise between male and female examinees. In addition to the EMG noise, decrease of PR interval was monitored in particular positional changes, which was prominent in male examinees. These results will enlarge fundamental understanding about EMG noise in ECG.

The Factors Causing Change of Lifestyle by the Outcome of Oriental Medical Examination (한방건강검진(韓方建康檢診) 결과(結果)에 따른 생활행동(生活行動) 변화(變化)에 영향(影響)을 미치는 요인(要因))

  • Na Sam-Sik;Kwon So-Hui;Seo Ji-Yeon;Jung Hae-Kyoung;Kim Yoo-Chul;Song Yung-Sun;Jang Du-Seop;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.139-150
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    • 2003
  • This study tried to know the chang of lifestyle and the factors causing of lifestyle change by the outcome of oriental medical examination for labors in one of the automobile factories in Jeon Buk area. The results will be helpful to the effective health care for the labors in factory. Oriental medical examination was done 22 times from May 20 to June 19, 2002. The numbers of labor who received oriental medical examination were 531, and 300 questionnaires among them were collected. The results were as follows: 1) General characteristics of examinee for oriental medical examination; total 300 labors, high percentage in age range $31{\sim}45$ years old, mostly married, high percentage of high school in completion of study. High percentages in drinking, smoking, and working hour were less than 1 time per week, non-smoking, and above 10 hours, respectively. High percentages in working year and salary were $11{\sim}15$ years. 2) The degree of lifestyle change by the oriental medical examination had the highest score with consult of oriental medicine doctor, and the lowest score was from moire typography result. 3) The degree of lifestyle change by medical examination was highly influenced by the subject characteristics that were less than 1 time per week for drinking, non-smoking, and less than 10 years of working year. 4) For the lifestyle change by the cognition of subject, the subjects who had high confidence for oriental medical examination, high recognition for oriental medical examination's requirement, high concern for health. effective cognition for early detection of disease, had high degree of lifestyle change. 5) The variables that cause lifestyle change in Sasang constitutional analysis result were early detection of disease, type of smoking, working year, moire typography result, interview for health. The variables that cause lifestyle change in moire typography result were type of drinking, ages, working year, consult for health, moire typography result. The variables that cause lifestyle change in interview with oriental medicine doctor were constitutional analysis and moire typography result.

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A Study on the standardization of EAV(Electroacupuncture acc.Voll)'s measurement values (EAV 측정치(測定値)의 표준화(標準化)에 관(關)한 연구(硏究) (성별(性別), 연령별(年齡別), 체질별(體質別)))

  • Cha, Chul Ju;Lee, Sang-Ryong;Lee, Ui-Ju;Hong, Seok-Cheol;Kim, Jong-Won;Go, Byeong-Hui;Song, Il-Byeong
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.2
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    • pp.131-150
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    • 1996
  • 1. Result As the study for standardization of EAV's measurement values according to constitution and sex and age, the questionnaire on QSCC and QSCC(I) and EAV were carried out to 603 general patients in east : west promotion health center affiliated to Kyung Hee Medical center. The following conclusions were reached as the result of statistical handling of the data of questionnaire and EAV. 1) Each standard scope of BAZ and CMP was suggested. 2) BAZ and CMP examined about constitution did not show any statistical difference. 3) The result of examination by sex on BAZ and CMP is such as followings. A meaningful difference was showed at the level of p<0.001 in HH, HEL, HFR, and FF in case of male on BAZ. meaningful difference were showed at the level of p<0.001 in R3, R4, R18, L3, L16 and L18 and at the level of P<0.01 In R5, R8, R12, L7, L9, L10, L11, and L13 and at the level of P<0.05 in R1, R2, R6, R11, R13, R14, R16, R17, R19, R20, L1, L2, L4, L5, L14, L17, and L19 in case of male on CMP. There was no statistical difference in R7, R9, R10, R15, L12, and L15. 4) In every measure point of both BAZ and CMP a meaningful difference was notified at the level of P<0.01 by age. 2. Suggestion 1)Environmental, examinee and examiner's factors which may cause error in EAV measurement should be excluded. 2)The factor of change by time and space should be clarified. 3)The correlation between disease and meridian should be learned. And scopes of BAZ and CMP according to disease should be studied.

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The Association of AUDIT Levels with Obesity Indices, Liver Function Tests, and Serum Lipid Levels in Male Health Checkup Examinees (건강검진 남성 수검자들의 알코올장애선별검사(AUDIT) 수준과 비만지표, 간기능검사치 및 혈청지질치와의 관련성)

  • Kim, Seok-Ju;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.5
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    • pp.3230-3242
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    • 2015
  • In this study, in an attempt to elucidate the relevance and the association between AUDIT level and health related indices such as obesity-related indices (BMI, waist circumference, body fat percentage), serum liver-enzyme levels (AST, ALT, GGT, total bilirubin) and serum lipid levels (TC, TG, HDL-C, LDL-C), data about including results of health checkup examination and questionnaire from 558 male examinees of 30-79 years old, who received a comprehensive health examination in the health promotion center of a university hospital during the period of January 1 to December 31, 2012, was analysed. As a results, the distribution of AUDIT rating of subjects was Zone I 58.2%, Zone II 25.3%, Zone III 7.0%, and Zone IV 9.5%. And AUDIT levels have significant relevance with age, smoking, body fat, GGT and TG. Especially, for the waist circumference, GGT and TG, the odds ratio indicating abnormality significantly increased in the higher AUDIT groups (Zone II~Zone IV) than a low-grade group (Zone I). This suggests that drinking problem with a high AUDIT level has a significant relevance with an abnormal increase of indices for obesity, serum liver-enzyme levels, serum lipid levels.

Effects of Korean Food-based Dietary Inflammatory Index Potential on the incidence of diabetes and HbA1c level in Korean adults aged 40 years and older (40세 이상 성인 한국인에서 한국형 식사염증지표 수준에 따른 당뇨병 발생률 및 당화혈색소 수준 변화 연구)

  • Yoon, Hyun Seo;Shon, Jinyoung;Park, Yoon Jung
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.263-277
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    • 2022
  • Purpose: The present study examined the associations of Korean Food-based Index of Dietary Inflammatory Potential (FBDI) scores with the prevalence of diabetes and hemoglobin A1c (HbA1c) level of diabetes patients in Korean adults. Methods: The Korean Genome and Epidemiology Study (KoGES) Health Examinee baseline data, collected between 2004 and 2013 and followed up between 2012 and 2016, were used in our study. A total 56,391 participants including diabetes (n = 5,733) and non-diabetes (n = 50,658) were analyzed. The subjects were classified into quartiles of FBDI scores using the semi-quantitative food-frequency questionnaire developed for KoGES. The prevalence rate of diabetes under FBDI scores was assessed by Cox proportional risk models and the severity of the diabetes was analyzed by multiple regression analysis. Results: There were 775 incident cases of diabetes after a mean follow-up of 3.97 years. There was no statistically significant association between FBDI scores and incidence of diabetes. Among diabetes patients at baseline, FBDI scores were related to the risk of progression of diabetes which was represented by greater than 9% HbA1c (Q1 vs. Q4; odds ratio, 1.562 [95% confidence intervals, 1.13-2.15]; p for trend = 0.007). The stratified analysis showed a stronger association in females, irregular exercise group, and higher body mass index group. Conclusion: These results suggest that a pro-inflammatory diet is not associated with the incidence of diabetes but is related to the HbA1c level of diabetes patients. Thus, further longitudinal studies with longer periods are required to determine a relationship between dietary inflammatory index and diabetes in Korea.

Differences in Psycho-physiological Responses Depending on Rapport-building During Polygraph Test (폴리그래프 검사에서 라포 형성에 따른 심리생리적 반응 차이)

  • Kim, Hyeonji;Jo, Eunkyung
    • Korean Journal of Forensic Psychology
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    • v.12 no.1
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    • pp.53-73
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    • 2021
  • This study is an experimental study comparing the psycho-physiological response differences of subjects according to the rapport building in polygraph tests. We randomly assigned 84 adults into a 2(veracity: Truth vs. Lie) x 2(rapport; Rapport building vs. Non-rapport building) between-subject design and measured ESS total scores as psycho-physiological responses. In order to manipulate the veracity conditions, participants in the truthful condition were told to tell their actual scores on several simple tasks but those in the lie condition were asked to tell higher scores than their actual scores. Afterwards all participants were polygraph tested in the order of pre-interview and main examination. The rapport conditions were manipulated by structured pre-interview scripts. As a result, there were significant differences in the examinee's total ESS scores depending on the veracity and rapport conditions. For truth-tellers, the ESS total scores were greater in the positive(+) direction in the rapport building condition than in the non-rapport building condition, indicating a prominent true response in the former condition. For liars, however, the ESS total scores were not significantly greater in the negative(-) direction in the rapport building condition than in the non-rapport building condition. Based on this study's results, we discussed the importance of rapport building in the pre-interview phase of a polygraph test and the need to operationalize verbal and non-verbal rapport building techniques.

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A study of sagittal condylar inclination and occlusal plane inclination of two semiadjustablearticulators with different reference plane (기준면이 다른 반조절성 교합기의 전방시상과로각과 교합평면경사각에 대한 연구)

  • Kim, Hyo-Jung;Lee, Sung-Bok;Choi, Dae-Gyun;Bak, Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.4
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    • pp.420-430
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    • 2008
  • Statement of problem & Purpose: Articulators are very important for education and overall clinical situation in the field of prosthodontics, however preexisting articulators are designed and built based on maxillofacial structures and mean values of mandibular movement of Western people. Purpose of this research is to find out a adequate basis for applicating these articulators, presently used for clinical education, for Korean. Material and methods: 59 Korean adults (41 males, 18 females), aged between 24 to 41, where selected for this study. Two pairs of both maxillary and mandibular models were made for each examinee. These models where attached to both KaVo PROTARevo 7 and Hanau Modular semiadjustable articulators by using facebow transfer, than sagittal condylar inclination, occlusal plane inclination and position of mandibular on the articulator where measured. Result and conclusion: 1. Mean sagittal condylar inclination for KaVo PROTAR semiadjustable articulator was $33.75^{\circ}$(standard deviation $12.46^{\circ}$) meanwhile Hanau Modular semiadjustable articulator showed $40.72^{\circ}$(standard deviation $12.09^{\circ}$) for mean sagittal condylar inclination. 2. Mean occlusal plane inclination for KaVo PROTAR semiadjustable articulator was $-2.76{\circ}$(standard deviation $3.63^{\circ}$) meanwhile Hanau Modular semiadjustable articulator showed $11.87^{\circ}$ (standard deviation $3.63^{\circ}$) for mean occlusal plane inclination. 3. On the average center of the mandibular dentition were in the range of 5 to 7 mm of the central position of the articulator. Both anterior and posterior dentition were positioned at the center of the articulator vernacularly for KaVo PROTAR semiadjustable articulators, meantime for Hanau Modular semiadjustable articulator, anterior dentition was positioned 5 mm downwards and 3mm upwards for posterior dentition from vertically central position of the articulator.

Estimated Exposure Dose and Usage of Radiological Examination of the National Health Screening (국가건강검진의 방사선검사 이용량 및 피폭선량 추정)

  • Gil, Jong Won;Park, Jong Hyock;Park, Min Hui;Park, Chan Young;Kim, So Young;Shin, Dong Wook;Kim, Won Dong
    • Journal of Radiation Protection and Research
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    • v.39 no.3
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    • pp.142-149
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    • 2014
  • Korea conducts a national health screening program to improve and check-up on public health and in recent years, the screening usage has been increased. Given the increased screening usage for radiographic exams, this study predicts the frequency of using radiographic exams and the exposure dose. This study estimates the usage of radiographic exams by isolating radiographic exams from the 2011 analysis of the national health insurance corporation, and estimates the public exposure dose by applying each procedure's dose table from UNSCEAR 2008. As a result of the analysis, in the 2011 National Health Screening, the average exposure dose per person is assumed to be 0.57 mSv, and depending on the type of screening program from the radiographic exam, an examinee could be exposed to between 0.2 mSv and 11.081 mSv. The frequency of using radiographic exposure was found to be 16,005,914 and the exposure dose was 6,311.76 person-Sv. The most frequent exam is the Chest X-ray, which was performed 1,070,567 (69.17%), and the UGI has the highest exposure dose at 5,217.94 person-Sv (82.67%). The outcome is categorized based on gender and age, excluding those under 39 years old. In all age groups, the screening usage and exposure dose are higher in females than in males. In particular, females between 50 and 54 years old have the highest screening usage (1,674,787, 10.5%) and exposure dose (701.59 person-Sv, 11.1%). As UGI accounts for 82.76% of procedures, except when done for medical purposes, if the government supports a voluntary UGI exam (which includes the UGI exam in the National Screening Program) or abolishes it completely, as seen overseas, the cost-effectiveness and validity of the UGI exam, as well as the exposure dose from the National Screening Program will all decrease significantly.

A Study on the Frequency of Occurrence of the Aortic Dissection using CT (CT 검사에서 대동맥박리(aortic dissection)의 발생빈도에 관한 고찰)

  • Dong, Kyung-Rae;Choi, Sung-Kwan;Jang, Young-Ill;Ro, Sang-Ho
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.115-121
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    • 2008
  • Purpose: Aortic Dissection is very dangerous, prognostic disease, which the bloodstream flow out of the true lumen of the aorta by the bursting of aortic intima resulting in a rapid dissociation of inner and outer layer from the media. It is difficult to diagnose aortic dissection clinically by normal X-ray. This study was to investigate the occurrence frequency by age and number of patients who are identified to be aortic dissection by CT (Computed Tomography) scan. Materials and methods: We investigated the trend of yearly fluctuation, gender, age, and department of clinical research of the 112 patients who conducted CT scan in C- University Hospital for two years from January 2005 to December 2006. The MIP and SSD which reconstructed CT image and the VRT image were obtained for the accurate observation. The result was investigated by comparing normal X-ray and CT scan. Results and Conclusion: 1. The yearly check of 112 patients conducted CT scan showed 37 people (41.9%) in 2005, and it was increased to 65 (58.1%) in 2006 by 1.4 times. 2. The gender distribution of patients given a CT scan showed 45 males (40.1%), and female 67 (59.9 %). The aortic dissection patients were 9 (20%) out of 45 males, 21 (31.3%) out of 67 females and women were 1.6 times more than men. Women are also 1.5 times more than men in the number of examinee. 3. The age distribution of patient's who conducted CT scan revealed that there was no patient under 30 years old while 88.3% of all patients were through 41 to 80 years old. The higher the age was, the higher the occurrence of aortic dissection was. The difference in the occurrence frequency of age was statistically significant (p<0.01). 4. The departments that requested CT scan were the emergency department 46 (41.1%), circulatory internal medicine 37 (33.0%), chest surgery 13 (11.6%), and others 6 (14.3%). The combined ratio of emergency medicine and circulatory internal medicine was 74.1% of all. The results show that the aortic dissection is a very dangerous disease whose patients visit mainly via the emergency room. 5. The aortic dissection patients had normal X-ray readings in 22 (73.3%) out of 30, and only 8 (26.7 percent) are abnormal in the X-ray diagnosis. Therefore, the CT scan needs to be enforced in order to assess accurately the disease of aortic dissection.

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