• Journal of Preventive Medicine and Public Health
• /
• v.40 no.3
• /
• pp.233-238
• /
• 2007

Objectives : We aimed to assess the relationship between long-term exposure to air pollution and lung cancer in the Republic of Korea. Methods : Using the Annual Report of Ambient Air Quality in Korea, Annual Report of National Cancer Registration, and Annual Report on the Cause of Death Statistics, we calculated the standardized mortality ratio (SMR) and standardized incidence ratio (SIR) of lung cancer for both sexes in 74 areas from 7 Korean metropolitan cities. We performed random intercept, Poisson regression using empirical Bayes method. Results : Both SMRs and SIRs in the 7 metropolitan cities were higher in women than in men. Mean SIRs were 99.0 for males and 107.0 for females. The association between $PM_{10}$ and lung cancer risk differed according to gender. $PM_{10}$ was not associated with the risk of lung cancer in males, but both incidence and mortality of lung cancer were positively associated with $PM_{10}$ in females. The estimated percentage increases in the rate of female lung cancer mortality and incidence were 27% and 65% at the highest $PM_{10}$ category $({\geq}70\;{\mu}g/m^3)$, compared to the referent category $({\geq}50\;{\mu}g/m^3)$. Conclusions : Long-term exposure to $PM_{10}$ was significantly associated with female lung cancer incidence in 7 Korean metropolitan cities. Further study is undergoing to estimate the relative risk of $PM_{10}$ using multi-level analysis for controlling individual and regional confounders such as smoking and socioeconomic position.

• Parasites, Hosts and Diseases
• /
• v.59 no.1
• /
• pp.61-65
• /
• 2021

Diarrheal disease is the second leading cause of mortality and morbidity in children under 5 years old worldwide, and is the most common cause of malnutrition in sub-Saharan Africa. In Rwanda, diarrhea is the third leading cause of death in children under 5 years old. This study examined the association between sociodemographic factors and diarrhea in children under 5 years using the data of 7,474 households in the 2014-2015 Rwanda Demographic and Health Survey. Overall prevalence of diarrhea in this study was 12.7% in children. An increased risk for diarrhea was found for children aged 12-23 months (odds ratio (OR)=4.514), those with a low economic status (OR=1.64), those from the Western province (OR=1.439), those with poorly-educated mothers (OR=5.163), and those with families engaged in agricultural activities (OR=1.624). In conclusion, sociodemographic factors significantly affect the risk of developing diarrhea in children under 5 years in Rwanda. Designing and implementing health education promoting awareness of early interventions and rotavirus vaccination are essential to reduce diarrheal diseases for the Rwandan community.

• The Korean Journal of Applied Statistics
• /
• v.37 no.2
• /
• pp.225-237
• /
• 2024

In the analysis of competing risks data, some of covariates may not be fully observed for some subjects. In such cases, excluding subjects with missing covariate values from the analysis may result in biased estimates and loss of efficiency. In this paper, we studied multiple imputation and the augmented inverse probability weighting method for regression parameter estimation in the cause-specific proportional hazards model with missing covariates. The performance of estimators obtained from multiple imputation and the augmented inverse probability weighting method is evaluated by simulation studies, which show that those methods perform well. Multiple imputation and the augmented inverse probability weighting method were applied to investigate significant risk factors for the risk of death from breast cancer and from other causes for breast cancer data with missing values for tumor size obtained from the Prostate, Lung, Colorectal, and Ovarian Cancer Screen Trial Study. Under the cause-specific proportional hazards model, the methods show that race, marital status, stage, grade, and tumor size are significant risk factors for breast cancer mortality, and stage has the greatest effect on increasing the risk of breast cancer death. Age at diagnosis and tumor size have significant effects on increasing the risk of other-cause death.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.14
• /
• pp.5685-5689
• /
• 2014

Background: It is well known that smoking is a preventable factor for all-cause mortality; however, it is still questionable how many years after smoking cessation that people will have reduced risk for mortality, in particular in those with a high interest in their own health. We aimed to examine the association between time since quitting smoking and total mortality among past-smokers relative to current smokers. Materials and Methods: We enrolled 36,446 health examinees that voluntarily taken with diverse health check-up packages of high cost burden in 1995-2003 and followed them till death by 2004. The history of cigarette smoking consumption was collected using a self-administrative questionnaire at the first visit time. Mortality risk by smoking cessation years was analyzed using Cox's proportional hazard model. Results: Compared to non-smokers, male smokers over 15 pack-years had higher risk for total mortality (HR=1.60, 95%CI 1.23-2.14). The mortality risk in female smokers with same pack-years was more pronounced than that in male smokers (HR=2.83, 95%CI 1.17-7.04) despite a small number of cases. Compared to current smokers, a decrease of total mortality was observed among those who ceased smoking, and inverse dose-response was found with years after cessation: RR 0.98 (95%CI, 0.64-1.41) (<2 yrs), 0.60 (95%CI, 0.43-0.83) (3-9 yrs), and 0.58 (95%CI, 0.43-0.79) (${\geq}10$ yrs). Conclusions: A reduced risk of total mortality was observed after 3 years of smoking cessation. Our findings suggest that at least 3 years of smoking cessation may contribute to reduce premature mortality among Asian men.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.23 no.6
• /
• pp.539-547
• /
• 2020

Purpose: Pediatric acute liver failure (PALF) is a serious condition; however, data on PALF in developing countries are sparse, particularly concerning molecular diagnosis and liver transplantation (LT). This study aimed to determine the causes, outcomes, and prognostic factors of PALF. Methods: We retrospectively reviewed the medical records of children (age <15 years) with PALF diagnosed using the American Association for the Study of Liver Diseases criteria at our center from 2011 to 2016. The collected data included laboratory results, complications, outcomes, and potential factors associated with death and LT. Results: We included a total of 27 patients, with a median age of 2 years (interquartile range, 3 months to 4 years). Viral infection was the most common etiology (n=8, 30%), predominantly dengue infection (n=4). A total of 16 patients (59%) died and 11 patients survived (3 patients with LT). The prognostic factors associated with death or LT requirement were grade IV hepatic encephalopathy (p<0.01), hypotension (p=0.02), gastrointestinal bleeding (p=0.03), increased intracranial pressure (p=0.04), and higher peak serum lactate level (p=0.01). Peak serum lactate ≥6 mmoL/L had a sensitivity of 79% and a specificity of 88% for predicting mortality or the necessity of LT. Conclusion: Viral infection was the most common cause of PALF. The mortality rate remained high, and a considerable number of patients required LT. In addition to several clinical factors, peak serum lactate could be a potential marker for predicting poor outcomes in PALF.

• Journal of Community Nutrition
• /
• v.6 no.3
• /
• pp.155-163
• /
• 2004

In our country, cardiovascular disease (CVD) and Coronary heart diseases (CHD) are the leading causes of death. It is well known that CHD is multifactorial, involving environmental factors such as diet, level of exercise and cigarette smoking, and inherited factors. According to the statistical data in 2003, the cause of death with the highest mortality was including hypertension, ischemic heart disease and atherosclerosis, which accounted for $24.7\%$ of total mortality. In spite of, there have been few study reports on the change of biochemical markers and mechanisms concerned. The development of biochemical markers is required for an early diagnosis and treatment of cardiovascular diseases that are related with dietary habits of Korean people enjoying mixtures of traditional dietary style and westernized food-styles. Therefore, the most efficient cost-saving biochemical marker was established in this study, through analysis of biochemical markers related with dietary habits which are susceptibly being changed in association to cardiovascular diseases from the pre-disease phase, and through reanalysis and assessment of early diagnosis of and preventive effects of diagnosis of cardiovascular diseases by demographical character including sex, age, and socioeconomic level with use of biochemical markers that are identified and selected among the parameters in consideration of the effectiveness and appropriateness of early diagnosis of diseases. The appropriateness of biochemical markers was reviewed by professionals (medical, pharmaceutical area and food/ nutrition area) and CRP(C-Reactive Protein) and was identified to be possible in Korea. It is thought that these biochemical markers may be used as the basic data for early diagnosis and prevention of cardiovascular diseases (CVD) which may be used for Korean people.

• Journal of Trauma and Injury
• /
• v.21 no.2
• /
• pp.100-107
• /
• 2008

Purpose: A traumatic lung cyst (TLC) is a rare complication and is usually detected with a pulmonary contusion. This study attempted to identify the prognostic factors and the clinical characteristics for pulmonary contusion with TLCs. Methods: We retrospectively reviewed the medical records and chest CT findings of 71 TLC patients who visited our hospital from January 2006 to December 2007. Patients were assessed for any clinical characteristics. We evaluated significant differences between the survival and the death groups for patients with a traumatic lung cyst. Results: The male-to-female ratio of patients with TLCs was 54:17, and the mean age of the patients was $37.70{\pm}19.78years$ with 36.6% of the patients being under 30 years fo age. The cause of blunt thoracic trauma was mainly pedestrian traffic accidents (26.8%) and falls (25.4%). Associated conditions included pulmonary contusion in 68 patients (95.7%), hemopneumothorax in 63 patients (88.7%), and rib fracture in 52 patitents (73.2%). There was no consistent relationship between the number of TLCs and the pulmonary contusion score. The overall mortality rate of TLC patients was 26.8%. Death correlated with a need for ventilatory assistance, mean arterial pressure, worst mean arterial pressure in 24 hours, initial pH and base excess, worst pH and base excess in 24 hours, refractory shock, initial GCS score, and pulmonary contusion score. Conclusion: The presence of the aforementioned predictors indicate serious injury, which is the main determinant of the outcome for thoracic injuries with TLCs.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.7
• /
• pp.3113-3118
• /
• 2012

Introduction: Cancer is the second cause of death in Kuwaiti people after cardiovascular diseases. This study is the first in the country to describe epidemiological measures related to cancer in this population. Methods: Data obtained from the Kuwait cancer registry included all Kuwaiti patients between years 2000-2009. Analyses were conducted using age-specific rates, the age-standardization-direct method, 95% confidence intervals (95% CI), cumulative risk by the age of 74 years, limited-duration prevalence, mortality and forecasting to year 2029. Results: It was noted that the commonest cancer sites were colorectal with an age standardized incidence rate (ASIR) of 16.1/100,000 in males and breast (49.4/100,000) in the female population. The trend of cancer incidence (1974-2009) showed no statistically significant change. First causes of death due to cancer were female breast 8(6.4-9.6)/100,000 and lung (males) 8.1/100,000 (6.6-10.0). The risk of developing cancer by the age of 74 was 13.4% (1/8) and 14.3% (1/7) in males and females respectively, and the risk of dying from cancer in the same age group was 1/17 and 1/23. By the end of 2009, prevalent cases represented 0.52% of the Kuwaiti population. In the year 2029, the total number of cancer cases is expected to reach 1200 cases compared to 889 cases in 2009. Conclusions and recommendations: The most common cancers in Kuwait (breast, colorectal and lung) are largely preventable. Prompt and effective interventional prevention programs that vigorously involve diet, anti-smoking and physical activity for both sexes are urgently required.

• Health Policy and Management
• /
• v.30 no.1
• /
• pp.26-36
• /
• 2020

Background: The purpose of this study was to analyze the relationship between the regional characteristics and the age-adjusted cardio-cerebrovascular disease mortality rates (SCDMR) in 229 si·gun·gu administrative regions. Methods: SCDMR of man and woman was used as a dependent variable using the statistical data of death cause in 2017. As a representative index of regional characteristics, health behavior factors, socio-demographic and economic factors, physical environment factors, and health care factors were selected as independent variables. Ordinary least square (OLS) regression and geographically weighted regression (GWR) were performed to identify their relationship. Results: OLS analysis showed significant factors affecting the mortality rates of cardio-cerebrovascular disease as follows: high-risk drinking rates, the ratio of elderly living alone, financial independence, and walking practice rates. GWR analysis showed that the regression coefficients were varied by regions and the influence directions of the independent variables on the dependent variable were mixed. GWR showed higher adjusted R² and Akaike information criterion values than those of OLS. Conclusion: If there is a spatial heterogeneity problem as Korea, it is appropriate to use the GWR model to estimate the influence of regional characteristics. Therefore, results using the GWR model suggest that it needs to establish customized health policies and projects for each region considering the socio-economic characteristics of each region.

• Journal of Chest Surgery
• /
• v.26 no.5
• /
• pp.365-372
• /
• 1993

We analyzed the patients who were admitted to Surgical Intensive Care Unit[SICU] of Kyungpook National University Hospital from January 1987 through December 1991. The results were as followings: The total number of patients for 5 years was 2446 and 1553[63.5%] were male,893[36.5%] were female. The average age was 34.1 years old and the greatest age group was the 1-9 age group.The number of the patients in the Department of Thoracic and Cardiovascular Surgery, which was the highest among all departments,was 1608 [65.7%].Congenital Heart disease was the most common among all diseases.The patients who had undergone any kinds of operations were 89.9% of all patients.The averge stay in SICU was 5.2 days.The overall mortality rate was 12.1% ,which included hopelessly discharged patients and the highest mortality rate occurred in the patients over 80 years old.The highest cause of death was cardiac problem[30.4%]. The next was sepsis.The proportion of patients who had received a mechanical ventilatory support was 35.7% and 52% of those patients belonged to the department of thoracic and cardiovascular surgery.