• Journal of Preventive Medicine and Public Health
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• 제24권2호
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• pp.221-231
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• 1991

A case-control study was conducted to investigate the risk factors (Part of job, Obesity, Alcohol, Smoking, Milk, Salt. and Family history) for hypertension. We selected 330 hypertension cases (male;247, female;83) and 1,336 controls (male;887, female;449) from employees in Taegu city from 1 May to 30 November, 1908. Data was analysed using a logistic regression model. Statistically significant elevated odds ratio were noted for alcohol (odds ratio=3.23), obesity (odds ratio=2.31), salt(odds ratio=1.75) in male (p<0.05) and those in female were noted for alcohol (odds ratio=16.49), family history(odds ratio=3.70), obesity (odds ratio=1.74) and salt (odds ratio=1.73) (p<0.05). Statistically significant reduced odds ratio was noted for milk in both sexes (odds ratio=0.69 for male and 0.65 for female)(p<0.05) and the dose-response relationship between milk intake and hypertension was confirmed (p<0.05). Therefore, milk seems to be preventive factor for hypertension. Smoking was not significantly associated with hypertension in both sexes. The part of job was significantly associated with hypertension in female by simple analysis (P<0.05) but the relationship was disappeared when multivariate analysis (logistic regression analysis) was done.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.85-101
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• 1995

This study was carried out to evaluate the associations between lifestyles and Body Mass Index in a group of 349 male and 65 female medical students, ages 17 to 31 years. 20.0% of male students and 3.1% of female students showed the over weight in the classification of obesity by Japan Society for Study of Obesity. There was no statistically significance in the comparison of the height, body weight, body mass index, obesity index and body fat(%) according to grade in both sexes. But male students showed increasing tendency of waist-hip ratio with grade. According to obesity category, there was significant difference in the comparison of body weight, body mass index, obesity index, waist-hip ratio and body fat(%), but height. Body mass index was positively related with waist-hip ratio(r=0.6150, p=0.0001) and fat(%)(r=0.5101, p=0.0001) in males and waist-hip ratio (r=0.4734, p=0.001) and fat(%)(r=0.4522, p=0.002) in females. This study provides an opportunity to further examine the relationship of sociddemographic factors and health behaviors to obesity, and suggest the basic concept to match the obesity study to general epidemiological cohort studies for controlling of chronic adult diseases.

• Health Policy and Management
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• 제27권2호
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• pp.114-120
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• 2017

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.

• Journal of Preventive Medicine and Public Health
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• 제19권1호
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• pp.91-99
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• 1986

To determine relationships of supposed risk factors to positives for HBsAg and Anti-HBs and also relationships of subjective symptoms to positives for HBsAg and Anti-HBs, study of 658 people working in the hospital, university, bank and other office was performed. Positive rate for HBsAg was about 7.9% and positive rate for Anti-HBs was about 20.0%. Odds ratio of HBsAg was high and significant in individuals who are married and who have previous hepatitis B(P<0.001), medical personnel in family, more than 4 people in a room(0.01

• Journal of Preventive Medicine and Public Health
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• 제44권5호
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• pp.218-225
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• 2011

Objectives: This study investigated the relationship between the blood mercury concentration and cardiovascular risk factors in elderly Korean individuals living in coastal areas. Methods: The sample consisted of 477 adults (164 males, 313 females) aged 40 to 65 years who visited a Busan health promotion center from June to September in 2009. The relationship between blood mercury concentration and cardiovascular risk factors including metabolic syndrome, cholesterol profiles, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), was investigated. Variables related to blood mercury concentration were further evaluated using multiple regression analysis. Results: The blood mercury concentration of the study population was 7.99 (range, 7.60 to 8.40) ${\mu}g$/L. In males, the blood mercury concentration was 9.74 (8.92 to 10.63) ${\mu}g$/L, which was significantly higher than that in females (7.21, [6.80 to 7.64] ${\mu}g$/L). The blood mercury concentration of the study population was related to several cardiovascular risk factors including low-density lipoprotein (LDL) cholesterol (p=0.044), high-density lipoprotein (HDL) cholesterol (p=0.034), BMI (p = 0.006), waist circumference (p = 0.031), and WHR (p < 0.001). In males, the blood mercury concentration was significantly correlated with WHR in the multiple regression analysis. Conclusions: In males, the blood mercury concentration was related to waist-to-hip ratio, which is a central obesity index and cardiovascular risk factor. Our finding suggests that cardiovascular disease risk in males was increased by mercury exposure via an obesity-related mechanism.

• Journal of Preventive Medicine and Public Health
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• 제48권4호
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• pp.188-194
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• 2015

Objectives: The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea. Methods: This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited. Results: Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance. Conclusions: Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.

• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.735-745
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• 1994

The incidence data (1991. 7. 1$\sim$1992. 6. 30) from the Implementation Study of Seoul Cancer Registry (ISSCR) 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 high fatality 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, MRI etc.). The level of 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 registery data merged with death certificate data regulary, and educate the registration stans to be more competent and dedicated.

• Journal of Preventive Medicine and Public Health
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• 제32권4호
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• pp.427-434
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• 1999

Objectives: This study was conducted to determine, by reviewing the literature, whether treatment of Helicobacter pylori infection in patients with non-ulcer dyspepsia affects symptoms. Methods: We retrieved the literature using MEDLINE search, with nonulcer dyspepsia and Hericobacter pylori and treatment as key words, which were reported from 1984 to 1998, and manual literature search. The criteria for inclusion was as follows; 1) The paper should have confirmed nonulcer dyspepsia as case definition. 2) The paper should have peformed a randomized, blind trial. 3) Confirmation of Helicobacter pylori eradication should be done 4 weeks after treatment. 4) studies with no information on measurement of symptoms after treatment were not accepted. The percentage of patients with symptom improvement after eradication therapy for Helicobacter pylori infection was calculated. Cumulative odds ratio was compared by fixed effect model and random effect model as sensitivity and funnel plot was used to evaluate publication bias. Results: The overall effect size of symptom improvement was calculated by cumulative odds ratio. Cumulative odds ratio of random effect model was 4.16(95% CI: 1.55-11.19). Before integrating each effect sizes into common effect size, the homogeneity test was conducted and random effect model was selected(Cochran's Q=41.08 (d.f=10, p<0.001)). The heterogeneity across studies was evaluated and the different methodological aspects of studies led to differences between study results Conclusions: The results suggest that the eradication of Helicobacter pylori in patients with non-ulcer dyspepsia results more symptom improvement. In studios that shows the opposite results there are methodological aspects explaining the heterogeneity.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.569-579
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• 1994

The genetically determined ability to metabolize debrisoquine (DBR) is related to risk of lung cancer and DBR hydroxylation exhibits wide inter-individual variation. In this study, 100 korean adults were tested for their ability to metabolize DBR. The DBR metabolic phenotype were determined by metabolic ratio (MR, DBR / 4-HDBR) which is the percent dose excreted as unchanged DBR divided by the percent dose excreted as 4-hydroxyebrisoquine(4-HDBR) in a aliquot of an eight hour urine sample, after 10mg DBR test dose administration. Analysis was performed on a capillary gas chromatograph fitted with electron capture detector. The results were as follows; 1 Geometric mean of DBR MR was 0.32 in male,0.27 in female,0.30 in total and the distribution of log (MR) was seemed to follow normal distribution. 2. Metabolic ratio of DBR was higher in non-smoker and non-drinker than in smoker and drinker without any statistically significant difference. 3. None of personal factors was significantly related to DBR MR except age. 4. The DBR metabolic phenotype was extensive metabolizer(EM) 93, intermediate metabolizer(IM) 7 by traditional method and EM 98, IM 3 by Caporaso's method. The poor metabolizer (PM) phenotype was not found by either method. 5. Maximal expected PM phenotype was 0.36% by traditional method and 0.04% by Caporaso's method.

• Journal of Preventive Medicine and Public Health
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• 제24권2호
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• pp.195-210
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• 1991

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following ; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are $40{\sim}50's$ in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows ; If the odds ratio of below 29 year of age is 1.0 then that of $30{\sim}39$ is 1.74 (p=0.33), $40{\sim}49$ is 2.47 (p=0.10), $50{\sim}59$ is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of $0{\sim}9$ is 5.08 (p<0.01), $10{\sim}19$ is 12.37 (p<0.01), $20{\sim}29$ is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of $100{\sim}120$ is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below $29{\mu}/1{\gamma}-GT$ is 1.0 then that of $30{\sim}s59$ is 2.11 (p<0.01), $60{\sim}90$ is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then $150{\sim}199$ is 1.49 (p=0.05), $200{\sim}250$ is 1.09 (P=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and nm triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.