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Progression-Free Survival: An Important Prognostic Marker for Long-Term Survival of Small Cell Lung Cancer

  • Park, Myoung-Rin;Park, Yeon-Hee;Choi, Jae-Woo;Park, Dong-Il;Chung, Chae-Uk;Moon, Jae-Young;Park, Hee-Sun;Jung, Sung-Soo;Kim, Ju-Ock;Kim, Sun-Young;Lee, Jeong-Eun
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.5
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    • pp.218-225
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    • 2014
  • Background: Small cell lung cancer (SCLC) is an extremely aggressive tumor with a poor clinical course. Although many efforts have been made to improve patients' survival rates, patients who survive longer than 2 years after chemotherapy are still very rare. We examined the baseline characteristics of patients with long-term survival rates in order to identify the prognostic factors for overall survivals. Methods: A total of 242 patients with cytologically or histologically diagnosed SCLC were enrolled into this study. The patients were categorized into long- and short-term survival groups by using a survival cut-off of 2 years after diagnosis. Cox's analyses were performed to identify the independent factors. Results: The mean patient age was 65.66 years, and 85.5% were males; among the patients, 61 of them (25.2%) survived longer than 2 years. In the multivariate analyses, CRP (hazard ratio [HR], 2.75; 95% confidence interval [CI], 1.25-6.06; p=0.012), TNM staging (HR, 3.29; 95% CI, 1.59-6.80; p=0.001), and progression-free survival (PFS) (HR, 11.14; 95% CI, 2.98-41.73; p<0.001) were independent prognostic markers for poor survival rates. Conclusion: In addition to other well-known prognostic factors, this study discovered relationships between the long-term survival rates and serum CRP levels, TNM staging, and PFS. In situations with unfavorable conditions, the PFS would be particularly helpful for managing SCLC patients.

Association between Pets and Asthma Symptoms in Korean Children - Focusing on Dogs and Cats - (반려동물과 아동의 천식증상과의 관계에 관한 연구 - 반려견 및 반려묘를 중심으로 -)

  • Cho, Jun Ho
    • Journal of Environmental Health Sciences
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    • v.46 no.1
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    • pp.11-21
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    • 2020
  • Objectives: The purpose of this study was to assess the association between pet ownership and asthma symptoms in Korean children. Methods: This study used data from the 8th Panel Study on Korean Children in 2015. For the final study, 1598 cases were used. Wheezing as an asthma symptom was self-reported as an outcome variable. Whether children had owned dogs or cats or not was used as an independent variable. Results: A total of 6.8% of children lived with dogs and 2.1% of children lived with cats in their homes. There were 4.0% of children who had asthma symptoms in the past year. When comparing 'children who had owned dogs for more than 12 months' with 'children who had not owned dogs', the adjusted odds ratio (OR) for 'asthma symptoms' were 1.20 (95% confidence interval (CI), 1.10-1.30) among male children and 2.19 (95% CI, 1.94-2.46) among female children. When comparing 'children who had owned cats for more than 12 months' with 'children who had not owned cats', the adjusted ORs for 'asthma symptoms' were 38.94 (95% CI, 35.55-42.65) among male children and 5.32 (95% CI, 4.60-6.16) among female children. When comparing 'children who had owned both dogs and cats for more than 12 months' with 'children who had not owned at all', the adjusted OR for 'asthma symptoms' was 13.22 (95% CI, 11.93-14.65), and when comparing 'children who had owned cats only' with 'children who had not owned at all', the adjusted OR for 'asthma symptoms' was 9.25 (95% CI, 8.50-10.08). Conclusions: As a result, children's asthma symptoms were higher in the case of cats than with dogs, and in the case of cats, boys were more at risk than girls. In the analysis for the risk of asthma symptoms when a dog and a cat are raised at the same time, it was statistically confirmed that the children in the home were more at risk than with single animal ownership. The results of this study can be considered to be of great importance in policy-making and for the use of educational materials in the field of environmental health.

Serum Ferritin and Risk of the Metabolic Syndrome in Some Korean Rural Residents (농촌 지역 주민의 혈청 Ferritin 수준과 대사증후군과의 관련성)

  • Ryu, So-Yeon;Kim, Ki-Soon;Park, Jong;Kang, Myeng-Guen;Han, Mi-Ah
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.2
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    • pp.115-120
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    • 2008
  • Objectives : The purpose of this study was to examine the relationship between serum ferritin and the metabolic syndrome (MS). Methods : We conducted a cross-sectional study of 1,444 adults over age 40 and under age 70 that lived in a rural area and participated in a survey conducted as part of the Korean Rural Genomic Cohort Study (KRGCS). The MS was defined as the presence of at least three of the followings : elevated blood pressure, low high density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, or abdominal obesity. After adjustment for age, alcohol intake, menopausal status, body mass index (BMI), high sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT), odds ratios (ORs) for the prevalence of the MS by sex were calculated for quartiles of serum ferritin using logistic regression analysis. Results : The MS was more common in those persons , with the highest levels of serum ferritin, compared to persons with the lowest levels, in men (37.1% vs. 22.4%, p=0.006) and women (58.8% vs. 34.8, p<0.001). In both sexes, the greater the number of MS components presents, the greater the serum ferritin levels. After adjustment for age, alcohol intake, and menopausal status, the OR for metabolic syndrome, comparing the fourth quartile of ferritin with the first quartile, was 2.21 (95% confidence interval; CI=1.26-3.87; p-trend=0.024) in men and 2.10 (95% CI=1.40-3.17; p-trend=0.001) in women. However, after further adjustment for BMI, hs-CRP, and ALT, the ORs were statistically attenuated in both sexes. Conclusions : Moderately elevated serum ferritin levels were not independently associated with the prevalence of the MS after adjusting for other risk factors. Further studies are needed to obtain evidence concerning the association between serum ferritin levels and the MS.

Short-term Effects of Ambient Air Pollution on Emergency Department Visits for Asthma: An Assessment of Effect Modification by Prior Allergic Disease History

  • Noh, Juhwan;Sohn, Jungwoo;Cho, Jaelim;Cho, Seong-Kyung;Choi, Yoon Jung;Kim, Changsoo;Shin, Dong Chun
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.5
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    • pp.329-341
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    • 2016
  • Objectives: The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients' prior history of allergic diseases. Methods: Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [$NO_2$], ozone [$O_3$], sulfur dioxide [$SO_2$], and particulate matter with an aerodynamic diameter <$10{\mu}m$ [$PM_{10}$]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season. Results: A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in $O_3$ concentration. IQR changes in $NO_2$ and $PM_{10}$ concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in $PM_{10}$ concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history. Conclusions: Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.

Association of Selected Medical Conditions With Breast Cancer Risk in Korea

  • Jung, Sun Jae;Song, Minkyo;Choi, Ji-Yeob;Song, Nan;Park, Sue Kyung;Yoo, Keun-Young;Kang, Daehee
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.6
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    • pp.346-352
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    • 2013
  • Objectives: To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study. Methods: The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer. Results: Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer. Conclusions: Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.

A Comparison of Influencing Factors on Yangseng(養生) Level in Urban and Rural Elderly (도시와 농촌지역 노인들의 양생수준에 영향을 미치는 요인 비교)

  • Chong, Dae-Seong;Chong, Myong-Soo;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.1-21
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    • 2007
  • The purpose of this research is to seek for efficient method of health improvement program for the old and to offer basic material for the development of community's public health service. This study investigated into the yangseng life level of the old and the factors which affect their yangseng life, and was to offer basic materials for oriental medicine-based health improvement plan which is appropriate for each community. The 818 surveys were conducted upon the old who are above 65 and who live in Jeollabukdo, and the results from the survey are as follows ; 1. The rural area showed more percentage of old people, the old who live alone and who have job compared to urban area. More people in rural area were found to live at their own expense. Additionally, there were more people who had high education in urban area and who have disease in rural area. 2. The total yangseng level of recipients was 94.20, and the average was 3.25. The average of urbanite was 3.26 and it was 3.23 for who live in rustic area, but there found no significant difference. All the old live in both urban area and rural area showed the highest score in morality yangseng and lowest in sex-life yangseng. 3. There found no difference upon regions, but the recipients show high yangseng level when they are male, have spouse, live with them, have factors including high education background, job, religion and hobby, or have confidence in their health. They also show high yangseng level when they do not have any disease in progress. 4. According to the results of general traits and yangseng level of each category, the old who live in urban area show higher exercise yangseng level than the one in rural area, and there is no significant difference upon the region in other categories. There were some cases which general traits and regional characteristics mutually affected each other. In conclusion, the yangseng level of the old is affected by individual traits and habits rather than the regions in which they live. The old who live in rural area are required to focus on exercise more, since the exercise yangseng level of them were lower than the ones of urban area. Moreover, there were some cases which general traits and regional characteristics mutually affected each other, so it requires further in-depth study about the correlation.

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Seroepidemiologic Study of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Infection among Koreans in Rural Area, Korea (농촌지역의 B형, C형 간염에 관한 혈청역학적 연구)

  • Shin, Hai-Rim;Kim, Joon-Youn;Song, Jue-Bok;Suh, Byung-Seong;Kim, Jung-Man;Lee, Bu-Ok;Kim, Su-Yang;Ryang, Mu-Guan;Lee, Chae-Un;Chun, Jin-Ho;Yoo, Keun-Young;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.1 s.56
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    • pp.17-29
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    • 1997
  • To estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and to determine associated risk factors, a population-based seroepidemiologic study was carried out. In 1993, a health examination survey of the population was carried out in rural area known to have a high incidence of liver cancer. The study population were those who volunteered to participate in a health survey over 10 years of age. Examinees were interviewed by specially trained staffs. Sera from 1,033 study subjects were tested for hepatitis B surface antigen (HBsAg) by .everse passive hemagglutinin (RPHA) estimation and for hepatitis C virus antibody (anti-HCV) by 2nd generation passive hemagglutinin (PHA) estimation. The age and sex standardized prevalence of HBsAg was 6.3% which was similar to national average, but that of anti-HCV was 5.1% which was 4 to 5 times higher than that of blood donors or other health examinees in Korea. In a multivariate analysis, transfusion history, surgical operative history, and acupuncture history were not associated with HBsAg positivity. In contrast, acupuncture history (adjusted odds ratio[OR]=2.2 : 95% Confidence interval[CI] 1.0-4.7) and surgical operative history(adjusted OR=2.0 : 95% CI 1.0-4.1) were associated with anti-HCV positivity. The present study suggest that there is an highly endemic area of HCV infection in Korea and probably this endemicity is associated with a parenteral source of HCV infection other than blood transfusion.

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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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Effects of Job Strains on Absenteeism from Work (직업성 긴장과 근로자 결근)

  • Cha, Bong-Suk;Chang, Sei-Jin;Choi, Hong-Ryul;Kim, Hyong-Sik;Koh, Sang-Baek
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.505-512
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    • 1999
  • Objectives : The purpose of this study was to assess the relationship between job strains and absenteeism from work. Methods : The study design was cross-sectional, and the study subjects consisted of 1,166 workers who were employed in the small-sized industries. A self administered questionnaire was used to measure the general characteristics, job characteristics(job demand, job control), and social support(coworker support, supervisor support) at work. The Job Content Questionnaire(JCQ) was used to assess job demand(2 items) and decision lattitude(10 items). Social support at work (10 items) was measured using JCQ. Sick absence was collected using self-report and were rechecked by the attendance record of their company. Odds ratios and 95% confidence intervals for the association between job strain and sick absence were estimated. The modifying effect of social support was evaluated by stratification. Logistic regression was used to estimate the relationship between job strain and sick absence. Results : In the bivariate analysis, the variables related to sick absence were age, marital status, occupation, job demand. Four distinctly different kinds of level of job strain were generated by the combination of job demand and job control: low strain group, high strain group, active group, and passive group. The crude odds ratio of high job strain was 1.78(95% CI: 1.26-2.53), and those of active group and passive group were 1.33(95% CI: 1.07-1.66) and 1.13 (95% CI: 0.88-1.47), respectively. The odds ratio of high job strain after adjusting for age and occupation were still significant The odds ratio of high job strain in low social support was 5.96(95% CI: 2.45-14.51), but that in high social support was 0.73(95% CI: 0.26-2.01). Conclusions : Job strain was associated with increased risk of absenteeism from work, and social support at work modified the association between job strain and sick absence.

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Incidence and Risk Factors for Diabetes Mellitus in Korean Middle-aged Men : Seoul Cohort DM Follow-up Study (우리나라 성인 남성 당뇨병의 발생양상과 위험요인에 관한 전향적 코호트 연구)

  • Kim, Dong-Hyun;Park, Sung-Woo;Choi, Moon-Gi;Kim, Dae-Sung;Lee, Moo-Song;Shin, Myung-Hee;Bae, Jong-Myon;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.526-537
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    • 1999
  • Objectives : It is known that the prevalence of diabetes mellitus(DM) appears to be rapidly increasing in recent times in Korea, presumably due to a westernized diet and change of life style followed by rapid economic growth. Based on the Seoul male cohort which was constructed in 1993, this study was conducted to estimate the annual incidence rates of DM through 4 years' follow up and to determine which factors are associated with DM risk in Korean middle-aged men. Methods : Among 14,533 men recruited at baseline, 559 were excluded because they reported a history of diabetes or were found to be diabetes at 1992 routine health examination. During 4 years' follow-up, 237 incident DM cases were ascertained through chart reviews and telephone contacts for those who have ever visited hospitals or clinics under suspicion of DM during 1993-1996 and the biennial routine health examinations in 1994 and 1996. Results : In this study the annual incidence of DM among the study population was estimated to be 0.5 per 100. This study showed that fasting glucose level at initial baseline examination was a powerful predictor of risk for diabetes several years later(fasting blood glucose of $\geq$ 110 mg/dl compared with $\leq$ 80 mg/dl, Hazard Ratio[HR]:15.6, 95% Confidence interval[CI]=9.1-26.6) after considering potential covariates such as age, family history, smoking and alcohol history, body mass index, physical activity, total energy intake, and total fiber intake. Adjusted hazard ratios of family history of diabetes was 1.95(95% CI=1.38-2.75); of obesity as measured by BMI(BMI $\geq$ 25.3 compared with $\leq$ 21.3) was 7.19(95% CI=3,75-13.8); of weight change during middle life(>10kg compared with $\leq$ 5) was 1.77(95% CI=1.16-2.69); of smoking(current vs none) was 1.93(95% CI=1.06-3.51); and fat intake(upper fertile compared with lower fertile) was 1.88(95% CI=1.01-3.49), while fiber intake was associated with the reduced risk(HR=0.36, 95% CI=0.19-0.67). Conclusion : The factors identified in this study indicate that the greatest reduction in risk of diabetes might be achieved through population-based efforts that promote fiber intake and reduce obesity, smoking, and fat intake.

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