• 대한한의학회지
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• 제28권4호
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• pp.42-51
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• 2007

Background and Purpose : To prevent ischemic cerebral infarction, it is very important to reduce risk factors which might cause stroke. However, the relationship of coffee consumption with ischemic cerebral infarction still remains unclear. The purpose of this study was to investigate the effects of coffee consumption on the risk of ischemic cerebral infarction in Koreans. Methods : A case-control study was conducted from April 1, 2001 to July 31, 2004. Cases (n=435) of first incident ischemic cerebral infarction were enrolled and were mostly matched by age to stroke-free hospital controls (n=407). All subjects were interviewed, examined and had anthropometric measurements by using an organized questionnaire. The coffee consumption was classified by the average frequency of intake, being none, 1 cup/day, 2-4 cups/day, more than 5 cups/day. Odds ratios (ORs) of ischemic cerebral infarction were proved multivariate analysis after adjustment for demographic factors, diet factors, and vascular risk factors. Results : When adjusted for sex, age, and other factors, coffee consumption and stroke do not have a significant association. (${\leq}$ cup/day OR=1.035, 95% CI=0.880-2.756; 2-4cups/day OR=1.452, 95% CI=0.864-2.440; ${\geq}$ 5 cups/day OR=1.557, 95% CI=0.705-3.435) Conclusions : In this study, we conclude that coffee consumption is not an important risk factor of ischemic cerebral infarction in Koreans. Prospective and cohort study on the relation between coffee consumption and the possibility of inducing ischemic cerebral infarctions in Koreans will be required in the future.

• 보건행정학회지
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• 제31권2호
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• pp.180-187
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• 2021

Background: This study analyzed the effect of applying the diagnosis-related group (DRG)-based payment system, which was implemented in July 2012 for hospitals and clinics nationwide, on the cesarean section rate. Methods: The subjects of the study were divided into new groups that participated in the payment system after July 2012 and maintenance groups that participated in the payment system before July 2012. As an analysis method, a difference-in-difference analysis, which is a quasi-experimental design, was used. The risk-adjusted cesarean section rate was used as a dependent variable. Results: Seven risk factors (malpresentation of fetus, eclampsia, multiple pregnancies, problems in the placenta, previous Cesarean section, cephalopelvic disproportion, problems in amniotic fluid) were included in the final risk-adjustment model, and found to have a statistically significant relationship with the cesarean section rate. Results showed that the risk-adjusted cesarean section rate increased significantly in new groups after the application of the DRG-based payment system. Conclusion: Study results provided policy implications for the reorganization of the DRG-based system should that reflects the demands of obstetricians, such as organizing a consultative body with obstetricians and establishing a reasonable fee.

• Journal of Nutrition and Health
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• 제41권5호
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• pp.402-413
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• 2008

This study was performed to investigate Apolipoprotein E phenotypes and the relationship among lipid levels, nutrient intakes, lifestyles and risk factors between subjects with and without hyperlipidemic risk. The data were collected from 675 industrial male workers who had completed annual medical examination. Compared to the normal group, the hyperlipidemic risk group in Apo E3 and E4 had significantly higher BMI (p < 0.05) and showed significantly higher body fat (%), waist circumference and WHR in all types of Apo E (p < 0.05). In addition, the hyperlipidemic risk group had significantly higher total cholesterol, LDL-cholesterol, triglyceride and AI than the normal group in all types of Apo E (p < 0.05). Intakes of protein, calcium, phosphorus, iron, vitamin A, vitamin B1, vitamin B2, vitamin C and niacin in Apo E3 were significantly lower in the hyperlipidemic risk group than in the normal group (p < 0.05). In the logistic regression analysis, after adjustment for other factors, Apo E2 + E4, waist and WHR were the significant risk factors associated with hyperlipidemia, but protein intakes were associated with significantly lower risks of hyperlipidemia (p < 0.05). In conclusion, genetic factor (Apo E2 or Apo E4), anthropometric index and nutrient intake seem to influence hyperlidemic risk. Further studies and efforts will be needed to evaluate the independent relationships among hyperlipidemic risk factors.

• Journal of Preventive Medicine and Public Health
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• 제57권2호
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• pp.108-119
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• 2024

Objectives: Abrupt changes in air pollution levels associated with the coronavirus disease 2019 (COVID-19) outbreak present a unique opportunity to evaluate the effects of air pollution on influenza risk, at a time when emission sources were less active and personal hygiene practices were more rigorous. Methods: This time-series study examined the relationship between influenza cases (n=22 874) and air pollutant concentrations from 2018 to 2021, comparing the timeframes before and during the COVID-19 pandemic in and around Thailand's Khon Kaen province. Poisson generalized additive modeling was employed to estimate the relative risk of hospitalization for influenza associated with air pollutant levels. Results: Before the COVID-19 outbreak, both the average daily number of influenza hospitalizations and particulate matter with an aerodynamic diameter of 2.5 ㎛ or less (PM_2.5) concentration exceeded those later observed during the pandemic (p<0.001). In single-pollutant models, a 10 ㎍/m³ increase in PM_2.5 before COVID-19 was significantly associated with increased influenza risk upon exposure to cumulative-day lags, specifically lags 0-5 and 0-6 (p<0.01). After adjustment for co-pollutants, PM_2.5 demonstrated the strongest effects at lags 0 and 4, with elevated risk found across all cumulative-day lags (0-1, 0-2, 0-3, 0-4, 0-5, and 0-6) and significantly greater risk in the winter and summer at lag 0-5 (p<0.01). However, the PM_2.5 level was not significantly associated with influenza risk during the COVID-19 outbreak. Conclusions: Lockdown measures implemented during the COVID-19 pandemic could mitigate the risk of PM_2.5-induced influenza. Effective regulatory actions in the context of COVID-19 may decrease PM_2.5 emissions and improve hygiene practices, thereby reducing influenza hospitalizations.

• 한국산학기술학회논문지
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• 제13권6호
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• pp.2672-2679
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• 2012

본 연구는 급성심근경색증 환자의 사망률 측정을 위한 중증도 보정 모형을 개발하여 의료의 질 평가에 필요한 기초자료를 제공하고자 수행되었다. 이를 위해서 질병관리본부의 2005-2008년 퇴원손상환자 699,701건의 자료를 분석하였다. Charlson Comorbidity Index 보정 방법을 이용한 경우와 새롭게 개발된 중증도 보정 모형의 예측력 및 적합도를 비교하기 위해 로지스틱 회귀분석을 실시하였다. 새롭게 개발된 모형에는 연령, 성, 입원경로, PCI 유무, CABG 유무, 동반질환 12가지 변수가 포함되었다. 분석결과 CCI를 이용한 중증도 보정 모형보다 새롭게 개발된 중증도 보정 사망 모형의 C 통계량 값이 0.796(95%CI=0.771-0.821)으로 더 높아 모형의 예측력이 더 우수한 것으로 나타났다. 본 연구를 통하여 중증도 보정 방법에 따라 사망률, 유병률, 예측력에도 차이가 있음을 확인하였다. 향후에 이모형은 의료의 질 평가에 이용하고, 질환별로 임상적 의미와 특성, 모형의 통계적 적합성 등을 고려한 중증도 보정모형이 계속해서 개발되어야 할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제39권6호
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• pp.447-454
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• 2006

Objectives : To determine obesity for the screening of individuals at high risk of coronary heart disease in urban areas. Methods : Data were obtained from 4,137 adults between 19 and 85 years of age (2,372 males, 1,765 females), not recognized as taking medicines for cardiovascular diseases, who underwent a health check-up at the health promotion center of university hospitals in cities between Jan. 2003 and Dec. 2004. The variables studied were divided into two broad categories, and their relationships examined. obesity indices and risk factors for coronary heart disease. To reveal the relation between each of the obesity indices and the proportion of individuals at risk of coronary heart disease, the obesity indices were stratified and odds ratios obtained after age adjustment. Results : From a gender comparison of anthropometric measures, men were found to have significantly greater heights, weights, and waist and hip circumferences than women. From a gender comparison by the obesity indices, women were found to have significantly higher BMI, %Fat, waist to hip and waist to stature ratios than men. As obesity indices, the waist to stature ratio and the waist circumference were strongly correlated with coronary risk factors, both in men and women. The age-adjusted odds ratio of coronary risk factors increased significantly with increasing waist circumference, BMI, %fat, waist to hip and waist to stature ratios, and were highest specifically for the waist to stature ratio and the waist circumference. Conclusions : The study results showed that the waist to stature ratio and the waist circumference, as obesity indices, were most closely correlated with coronary risk factors. It is suggested that the waist to stature ratio and, specifically, the waist circumference can be effectively used in the field of health management for screening those with high levels of coronary risk factors.

• 대한의생명과학회지
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• 제16권3호
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• pp.169-177
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• 2010

Osteoporosis is a disease that increases the fracture rates and a major cause of increased mortality and morbidity in the elderly people. This study is to determine which components of body composition and metabolic syndrome risk factors are important to bone health, we analysed the relationship among bone mineral density (BMD), body composition and metabolic syndrome risk factors in females. Totally 630 females participated in a medical check-up program (mean age 47 years) were selected for this study. Body composition analysis was performed by segmental bioelectrical impedance method, muscle mass, and percent body fat were measured. We also measured metabolic syndrome risk factors including abdominal obesity, HDL-cholesterol, triglyceride, blood pressure and fasting glucose level. Metabolic syndrome was defined by NCEP-ATP III criteria. The lumbar spine and femoral neck BMD were measured using the dual energy X-ray absorptiometry. Osteopenia and osteoporosis were observed in 180 and 51 persons, respectively. Muscle mass and HDL-cholesterol decreased in osteopenia and osteoporosis groups compared to the control group, and the grade was shown progressively by the symptoms. Significant positive correlation between BMD and muscle mass was observed. Multi variable regression analyses showed that % body fat and muscle mass were independent predictors of BMD after adjustment of age, height and weight. In conclusion, the BMD showed negative correlation with the metabolic and body composition was associated with BMD.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7355-7358
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• 2013

Several lines of evidence support the notion that MUC1 is often aberrantly expressed in gastric cancer, and it is a ligand for Helicobacter pylori. Genetic variation in MUC1 gene may confer susceptibility to H. pylori infection and gastric cancer. We assessed the association of common polymorphisms in MUC1 gene with H. pylori infection and non-cardia gastric cancer using an LD-based tag SNP approach in north-western Chinese Han population. A total of four SNPs were successfully genotyped among 288 patients with non-cardia gastric cancer and 281 age- and sex-matched controls. None of the tested SNPs was associated with H. pylori infection. SNP rs9426886 was associated with a decreased risk of non-cardia gastric cancer, but lost significance after adjustment for multiple testing. Overall, our data indicated that common genetic variations in MUC1 gene might not make a major contribution to the risk of H. pylori infection and non-cardia gastric cancer in our studied population.

• Journal of Nutrition and Health
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• 제37권3호
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• pp.202-209
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• 2004

A case-control study was conducted in order to examine dietary behavioral factors associated with colorectal cancer risks. Data were collected from 128 cases with either colorectal cancer or large bowl adenomatous polyps and 129 controls regarding stages of dietary behavioral change, perceived barrier, self efficacy, nutrition knowledge, social support and food availability as well as body mass index and overall dietary quality. Cases showed less desirable behaviors with respect to fat reduction and vegetable intake compared with controls based on the analyses of the stages of dietary change. After adjustment of relevant covariates (age, gender and smoking), significant trends of increasing risk with higher level emerged for perceived barriers resulted from environmental conditions (OR = 1.6 - 2.0) and self-efficacy (OR = 2.2-2.3). No such relationships were found for nutrition knowledge and social support. The risk of colorectal cancer was associated with the kinds of foods available at home showing a borderline protective relation with milk (OR = 0.6) and respective significant and borderline direct associations for fresh meat (OR = 2.1) and soft drinks (OR = 0.6 when reversely scored). Within-group analyses presented best predictors of overall dietary quality as food availability for the case and self-efficacy and social support for the control. The findings of this study suggested a need for focusing on motivational and reinforcing factors in the development of nutrition education programs for colorectal cancer prevention.

• 한국간호교육학회지
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• 제29권1호
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• pp.31-60
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• 2023

Purpose: This study explored the influencing factors on suicide-related behaviors (ideation, plans, and attempts) focusing on mental health problems (anxiety, depression, and loneliness) among Korean adolescents. Methods: A secondary analysis was conducted with data from the 16th Korean Youth Health Behavior Survey collected from in 2020 by the Korea Centers for Disease Control and Prevention. Chi-square tests and multivariate logistic regression analyses were performed. Results: After the adjustment of demographic characteristics and health risk behaviors, the influences of mental health problems on suicidal ideation, plans, and attempts showed the anxiety odds ratio (OR) for severe anxiety vs. minimal (OR 4.65, 4.67, and 3.75), depression (OR 4.27, 3.69, and 4.49), loneliness (OR 2.18, 1.96, and 1.96). Health risk behaviors (violence experience, drug use, stress, smoking, and drinking alcohol) and demographic variables (gender, school record, and socioeconomic status) were also significantly associated with suicide-related behaviors. Conclusion: Anxiety, depression, and loneliness were strong predictors of suicide-related behaviors. Early detection of suicide risks through screening for comprehensive mental health problems was recommended. Suicide prevention that considers the risk factors, including mental health problems and other risk factors, needs to be developed and implemented to reduce suicide risks among adolescents.