• Journal of agricultural medicine and community health
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• v.45 no.2
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• pp.79-88
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• 2020

연구목적: 이 연구는 지역사회 치면열구전색 사업의 치아우식 예방효과를 평가하고자 시행되었다. 연구방법: 연구 대상자는 2005년부터 2008년까지 김천시에 소재한 34개 초등학교에 재학 중인 9,001명 중 2005년 최초 구강검사 당시 상·하악 제1대구치에 치아우식이 없는 치아와 학생 4,768명을 최종 대상자로 선정하였다. 2005년도에 치면열구전색을 실시한 1,478명에 대해 3년간 추적조사가 이루어졌고, 2006년에 치면열구전색을 실시한 999명에 대해 2년간 추적조사를 하였으며, 2007년에 치면열구전색을 실시한 458명에 대해 1년간 추적조사 후 기술통계 및 교차분석을 시행하였다. 연구결과: 치면열구전색 실시군의 DMFT rate는 1년 추적 후 1.4%에서 3년 추적 후 4.1%, DMFT index는 1년 추적 후 0.18개에서 3년 추적 후 0.70개로 추적기간이 길어질수록 높게 나타났다. 1일 평균 칫솔질 횟수는 DMFT rate와 DMFT index에 영향을 미쳤다. 즉 치면열구전색을 실시한 대상자라도 1일 평균 칫솔질 횟수가 적으면 DMFT rate와 DMFT index는 높게 나타났다. 결론: 치면열구전색을 실시한 대상자에서도 올바른 칫솔질에 대한 구강보건교육이 선행되어야 한다.

• Health Policy and Management
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• v.27 no.2
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• pp.149-156
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• 2017

Background: This study was conducted to evaluate the performance of the Hierarchical Condition Category (HCC) model, identify potentially high-cost patients, and examine the effects of adding prior utilization to the risk model using Korean claims data. Methods: We incorporated 2 years of data from the National Health Insurance Services-National Sample Cohort. Five risk models were used to predict health expenditures: model 1 (age/sex groups), model 2 (the Center for Medicare and Medicaid Services-HCC with age/sex groups), model 3 (selected 54 HCCs with age/sex groups), model 4 (bed-days of care plus model 3), and model 5 (medication-days plus model 3). We evaluated model performance using $R^2$ at individual level, predictive positive value (PPV) of the top 5% of high-cost patients, and predictive ratio (PR) within subgroups. Results: The suitability of the model, including prior use, bed-days, and medication-days, was better than other models. $R^2$ values were 8%, 39%, 37%, 43%, and 57% with model 1, 2, 3, 4, and 5, respectively. After being removed the extreme values, the corresponding $R^2$ values were slightly improved in all models. PPVs were 16.4%, 25.2%, 25.1%, 33.8%, and 53.8%. Total expenditure was underpredicted for the highest expenditure group and overpredicted for the four other groups. PR had a tendency to decrease from younger group to older group in both female and male. Conclusion: The risk adjustment models are important in plan payment, reimbursement, profiling, and research. Combined prior use and diagnostic data are more powerful to predict health costs and to identify high-cost patients.

• The Korean Journal of Applied Statistics
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• v.31 no.4
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• pp.529-538
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• 2018

Tuberculosis causes high morbidity and mortality. However, Korea still has the highest tuberculosis (TB) incidence and mortality among OECD countries despite decreasing incidence and mortality due to the development of modern medicine. Korea has now implemented various policy projects to prevent and control tuberculosis. This study analyzes the effects of public-private mix (PPM) tuberculosis control program on treatment outcomes and identifies the factors that affecting the success of TB treatment. We analyzed 130,000 new tuberculosis patient cohort from 2012 to 2015 using data of tuberculosis patient reports managed by the Disease Control Headquarters. A cumulative incidence function (CIF) compared the cumulative treatment success rates for each factor. We compared the results of the analysis using two popular types of competition risk models (cause-specific Cox's proportional hazards model and subdistribution hazard model) that account for the main event of interest (treatment success) and competing events (death).

• 대한예방의학회:학술대회논문집
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• 1994.02a
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• pp.681-691
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• 1994

The American Conference of Governmental Industrial Hygienists (ACGIH) has proposed a threshold limit value (TLV) for benzene of 0.1 ppm. Individuals representing the American Petroleum Institute (API)and the Chemical Manufacturers Association (CMA) have argued that 1) the risk assessment by Rinsky .et al. which ACGIH partially relied upon for its proposed TLV overestimates the risk; however, at the exposures levels of interest - (e.g., 0.1 to 1.0 ppm) for establishing a benzene TLV, the Rinsky et al. assessment provides lower estimates of leukemia risk than most others; 2) ACGIH should not use the Dow study for direct observational evidence of leukemia risk associated with low-level benzene exposure because of confounding exposure; however, it is unlikely that confounding exposures played a role in the excess of leukemia demonstrated in the study, and the Dow cohort was exposed to an average benzene concentration of about 5.5 ppm benzene for 7.11 years (31:1.5 ppm-years), while some of the individuals in the study who died from leukemia were exposed to an average of only 1.0 ppm without the opportunity for highpeak exposures; 3) the Occupational Safety and Health Administration (OSHA) established an 8-hour time-weighted average (TWA) of 1.0 ppm in 1987, and there is no new evidence that would justify reducing the TWA below that level; however, the OSHA TWA of 1.0 ppm was based on economic feasibility and the level of excess risk remaining at 1.0 ppm, i.e., 10 excess leukemia deaths per 1000 workers over an occupational lifetime (45 years) according to OSHA's preferred estimate leaves behind I risk considered significant by OSHA. In addition, chromosomal studies among workers and in animals exposed to benzene indicate that low-level exposure, i.e., 1.0 ppm, is associated with elevated Cytogenetic damage. On the basis of adverse health effects data alone, in this author's opinion, it would be poor science and poor public health policy to establish a benzene TLV greater than 0.1 ppm.

• Nutrition Research and Practice
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• v.7 no.3
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• pp.233-241
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• 2013

There are limited data on healthy dietary patterns protective against metabolic syndrome (MetSyn) development. We identified dietary patterns among middle-aged and older adults and investigated the associations with the incidence of MetSyn. A population-based prospective cohort study included 5,251 male and female Koreans aged 40-69 years. At baseline, all individuals were free of MetSyn, other major metabolic diseases, and known cardiovascular disease or cancer. Cases of MetSyn were ascertained over a 6-year of follow-up. Dietary patterns and their factor scores were generated by factor analysis using the data of a food frequency questionnaire. We performed pooled logistic regression analysis to estimate multivariable-adjusted relative risk (RR) and 95% confidence interval (CI) for associations between factor scores and MetSyn risk. Two dietary patterns were identified; (1) a healthy dietary pattern, which included a variety of foods such as fish, seafood, vegetables, seaweed, protein foods, fruits, dairy products, and grains; and (2) an unhealthy dietary pattern, which included a limited number of food items. After controlling for confounding factors, factor scores for the healthy dietary pattern were inversely associated with MetSyn risk (P-value for trend < 0.05) while those for the unhealthy dietary pattern had no association. Individuals in the top quintile of the healthy diet scores showed a multivariable-adjusted RR [95% CI] of 0.76 [0.60-0.97] for MetSyn risk compared with those in the bottom quintile. The beneficial effects were derived from inverse associations with abdominal obesity, low HDL-cholesterol levels, and high fasting glucose levels. Our findings suggest that a variety of healthy food choices is recommended to prevent MetSyn.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.517-524
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• 2018

Background Infantile hemangioma (IH) is a common vascular tumor in pediatric patients, and is commonly treated with propranolol. We describe our experiences with dosage, response to treatment, and side effects in 23 IH patients treated with propranolol. Methods For this nonrandomized comparative cohort study, the authors enrolled 23 patients treated with propranolol. Photographs were taken before propranolol administration and at 3, 6, 9, and 12 months after treatment. Treatment responses were objectively analyzed with a computer program. Results There were three male and 20 female patients. Common tumor locations were the head and neck (13 cases, 56.5%), trunk (four cases, 17.4%), extremities (three cases, 13.0%), and combined locations (three cases, 13.0%). The response to propranolol was significantly lower in patients with two or more lesions than in patients with a single lesion in terms of both color fading (P<0.001) and size reduction (P<0.001). In male patients ($42.2{\pm}3.9$), the change in a-values, indicating coloration, was higher than in female patients ($19.8{\pm}13.8$) (P<0.001). In patients who started treatment before 6 months after birth, the size reduction was greater than in their counterparts (62.3%; range, 3.0%-93.0% vs. 15.8%; range, 1.0%-79.0%; P<0.001). Conclusions Propranolol is an efficacious treatment with a good safety profile. In patients with a single lesion, the response to treatment was better in terms of color fading and size reduction. Furthermore, male patients responded better to propranolol treatment in terms of color fading than female patients, and starting treatment before 6 months after birth was more advantageous for size reduction.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1497-1500
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• 2014

Cervical cancer continues to be an important public health problem in Thailand. While the high risk human papillomavirus (HPV) types have been established as the principle causative agent of both malignancies and the precursor lesions, cervical intraepithelial neoplasia (CIN), other factors may also be involved like other sexually transmitted diseases, as well as smoking. Chlamydia trachomatis is an obligate intracellular Gramnegative bacterium which has a tendency to cause chronic infection featuring inflammation and therefore might be expected to increase the risk of cervical cancer. In the present nested case-control study, 61 cases of cervical cancer and 288 matched controls with original serum samples were identified from the Khon Kaen Cohort, established in the North-East of Thailand, by linkage to the Khon Kaen population based cancer registry. C. trachomatis specific IgG antibodies at recruitment were measured by microimmunofluorescence and assessed for association with cervical cancer using STATA release10. No significant link was noted either with all cancers or after removal of adenocarcinomas. The results suggest no association between Chlamydia infection and cervical cancer development in North-East Thailand, but possible influencing factors must be considered in any future research on this topic.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7701-7706
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• 2013

Background: In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. Materials and Methods: This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Results: Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. Conclusions: While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.

• Journal of Aquaculture
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• v.13 no.4
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• pp.317-323
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• 2000

Experimental cohorts of Mugil cephalus were divided into 5 groups : seawater~normal feed (SWN), acclimation to freshwater~normal feed (GFWN), acclimation to freshwater~salt feed (Gf\iVS), freshwater. normal feed (FWN) and freshwater-salt feed (f\iVS). Growth was faster in the SWN, Gf\iVS, and GFWN groups than in the f\iVS and FWN groups. Condition factor did not differ among the groups. Survival (92 %) of the juveniles was the highest in the Gf\iVS group; however, the others showed no significant difference. Moisture of FWN group was significantly higher than that of SWN group (P < 0.05). Potassium concentration was significantly higher in the SWN group than that of others (P < 0.05). It was highest (30 mmolfl) among the cohort of SWN.

• Biomedical Science Letters
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• v.21 no.4
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• pp.181-187
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• 2015

Osteoporosis is one of the diseases caused by accumulation of effects from complex interactions between genetic and environmental factors. Aging is the major cause for osteoporosis, which normally increases skeletal fragility and bone fracture especially among the elder. "Omics" refers to a specialized research field dealing with high-throughput biological data, such as genomics, transcriptomics, proteomics or metabolomics. Integration of data from multi-omics has been approved to be a powerful strategy to colligate biological phenomenon with multiple aspects. Actually, integrative analyses of "omics" datasets were used to present pathogenesis of specific diseases or casual biomarkers including susceptible genes. In this study, we evaluated the proposed relationship of novel susceptible genes (TREML2, HTR1E, and GLO1) with osteoporosis, which genes were obtained using multi-omics integration analyses. To this end, SNPs of the susceptible genes in the Korean female cohort were analyzed. As a result, one SNP of HTR1E and five SNPs of TREML2 were identified to associate with osteoporosis. The highest significant SNP was $rs6938076^*$ of TREML2 (OR=0.63, CI: 0.45~0.89, recessive P=0.009). Consequently, the susceptible genes identified through the multi-omics analyses were confirmed to have association with osteoporosis. Therefore, multi-omics analysis might be a powerful tool to find new genes associated with a disease. We further identified that TREML2 has more associated with osteoporosis in females than did HTR1E.