• Journal of Technologic Dentistry
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• v.30 no.2
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• pp.121-133
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• 2008

The purpose of this study was to evaluate the role of socioeconomic factors and health behaviors on the prevalence of oral diseases(dental caries and periodontal disease) among Korean adults. Data from the 2005 National Health and Nutrition Examination Survey was analyzed for adults aged over 19 years (n=25,215). Oral disease was defined as disease diagnosed by a dentist for the previous 12 months. Chi-square test and logistic regression analysis were used to conduct statistical analysis. The population without dental caries and periodontal diseases were used as the reference category for all analysis. The overall prevalence of annual dentist-diagnosed dental caries and periodontal diseases were 23.5% and 10.6% respectively. The relative risk of developing dental caries for graduates of middle school and lower were 1.53 times (95% CI: 1.24-1.89) more likely to develop dental caries comparing to college graduates. Low income earners were 1.23 times(95% CI: 1.01-1.49) more likely to develop dental caries than high income earners. Persons covered by national medical insurance were 1.45 times(95% CI: 1.08-1.95) more likely to develop dental caries comparing to persons covered by employee medical insurance. Compared with persons not eating snacks, the risk of developing caries in persons eating snacks once a day was 1.16(95% CI: 1.01-1.32), while those who snacked twice or more a day were 1.19(95% CI: 1.01-1.41). The relative risk of developing periodontal disease was 3.71(95% CI: 2.38-5.80) higher in older individuals than younger. In terms of education level, middle school graduates and lower were 1.54 times more likely to develop periodontal disease than college graduates. Low income earners were 1.47 times more likely to develop periodontal diseases than high income earners. Using data from a large, nationally representative sample of Korean populations, we support the hypothesis that the prevalence of oral diseases is related with socioeconomic factors and health behaviors. More intensive intervention efforts to reduce the prevalence of dental diseases are warranted in Korea.

• Nutrition Research and Practice
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• v.6 no.4
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• pp.349-356
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• 2012

Several studies have been conducted on dietary patterns based on carbohydrate nutrition in Asian populations. We examined the cross-sectional associations in dietary patterns based on carbohydrate nutrition, including the glycemic index (GI) with dyslipidemia and diabetes among the Korean adult population. We analyzed 9,725 subjects (3,795 men and 5,930 women, ${\geq}$ 20 years) from the Fourth Korea National Health and Nutrition Examination Survey. Dietary information was collected using single 24-hour recall. Reduced rank regression was used to derive dietary patterns from 22 food groups as predictor variables and four dietary factors related to the quantity and quality of carbohydrates as response variables. Two dietary patterns were identified: 1) the balanced pattern was characterized by high intake of various kinds of foods including white rice, and 2) the rice-oriented pattern was characterized by a high intake of white rice but low intake of vegetables, fruits, meat, and dairy products. Both patterns had considerable amounts of total carbohydrate, but GI values differed. The rice-oriented pattern was positively associated with hypertriglyceridemia in men and low high density lipoprotein-cholesterol in both men and women. The balanced pattern had no overall significant association with the prevalence of dyslipidemia or diabetes, however, men with energy intake above the median showed a reduced prevalence of diabetes across quintiles of balanced pattern scores. The results show that dietary patterns based on carbohydrate nutrition are associated with prevalence of dyslipidemia and diabetes in the Korean adult population.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2979-2982
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• 2016

Background: High dose ionizing radiation can induce ovarian cancer, but the effect of low dose radiation on the development of ovarian cancer has not been extensively studied. We evaluated the effect of low dose radiation and total background radiation, and the radiation delivered to the ovaries during the treatment of rectosigmoid cancer and breast cancer on ovarian cancer incidence. Materials and Methods: Background radiation measurements are from Assessment of Variations in Radiation Exposure in the United States, 2011. Ovarian cancer incidence data are from the Centers for Disease Control and Prevention. Standardized incidence ratios (SIR) of ovarian cancer following breast cancer and rectosigmoid cancer are from Surveillance, Epidemiology, and End Results (SEER) data. Obesity data by US state are from the Centers for Disease Control and Prevention. Mean ages of US state populations are from the United States Census Bureau. Results: We calculated standardized incidence ratios (SIR) from Surveillance, Epidemiology, and End Results (SEER) data, which reveal that in 194,042 cases of breast cancer treated with beam radiation, there were 796 cases of ovarian cancer by 120+ months of treatment (0.41%); in 283, 875 cases of breast cancer not treated with radiation, there were 1,531 cases of ovarian cancer by 120+ months (0.54%). The difference in ovarian cancer incidence in the two groups was significant (p < 0.001, two tailed Fisher exact test). The small dose of scattered ovarian radiation (about 3.09 cGy) from beam radiation to the breast appears to have reduced the risk of ovarian cancer by 24%. In 13,099 cases of rectal or rectosigmoid junction cancer treated with beam radiation in the SEER data, there were 20 cases of ovarian cancer by 120+ months of treatment (0.15%). In 33,305 cases of rectal or rectosigmoid junction cancer not treated with radiation, there were 91 cases of ovarian cancer by 120+ months (0.27%). The difference in ovarian cancer incidence in the two groups was significant (p = 0.017, two tailed Fisher exact test). In other words, the beam radiation to rectum and rectosigmoid that also reached the ovaries reduced the risk of ovarian cancer by 44%. In addition, there was a significant inverse relationship between ovarian cancer in white women and radon background radiation (r = - 0.465. p = 0.002) and total background radiation (r = -0.456, p = 0.002). Because increasing age and obesity are risk factors for ovarian cancer, multivariate linear regression was performed. The inverse relationship between ovarian cancer incidence and radon background was significant (${\beta}=-0.463$, p = 0.002) but unrelated to age (${\beta}=-0.080$, p = 0.570) or obesity (${\beta}=-0.180$, p = 0.208). Conclusions: The reduction of ovarian cancer risk following low dose radiation may be the result of radiation hormesis. Hormesis is a favorable biological response to low toxin exposure. A pollutant or toxin demonstrating hormesis has the opposite effect in small doses as in large doses. In the case of radiation, large doses are carcinogenic. However, lower overall cancer rates are found in U.S. states with high impact radiation. Moreover, there is reduced lung cancer incidence in high radiation background US states where nuclear weapons testing was done. Women at increased risk of ovarian cancer have two choices. They may be closely followed (surveillance) or undergo immediate prophylactic bilateral salpingo-oophorectomy. However, the efficacy of surveillance is questionable. Bilateral salpingo-oophorectomy is considered preferable, although it carries the risk of surgical complications. The data analysis above suggests that low-dose pelvic irradiation might be a good third choice to reduce ovarian cancer risk. Further studies would be worthwhile to establish the lowest optimum radiation dose.

• Journal of Preventive Medicine and Public Health
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• v.44 no.3
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• pp.131-139
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• 2011

Objectives: Masked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers. Methods: The study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension. Results: The frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129 /80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129/ 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139/ 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09). Conclusions: The frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.781-784
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• 2016

The Plurinational State of Bolivia (Bolivia) has a high incidence rate of gallbladder cancer (GBC). However, the genetic and environmental risk factors for GBC development are not well understood. We aimed to assess whether or not cytochrome P450 (CYP1A1), glutathione S-transferase mu 1 (GSTM1), theta 1 (GSTT1) and tumor suppressor protein p53 (TP53) genetic polymorphisms modulate GBC susceptibility in Bolivians. This case-control study covered 32 patients with GBC and 86 healthy subjects. GBC was diagnosed on the basis of histological analysis of tissues at the Instituto de Gastroenterologia Boliviano-Japones (IGBJ); the healthy subjects were members of the staff at the IGBJ. Distributions of the CYP1A1 rs1048943 and TP53 rs1042522 polymorphisms were assayed using PCR-restriction fragment length polymorphism assay. GSTM1 and GSTT1 deletion polymorphisms were detected by a multiplex PCR assay. The frequency of the GSTM1 null genotype was significantly higher in GBC patients than in the healthy subjects (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.03-5.37; age-adjusted OR, 3.53; 95% CI, 1.29-9.66; age- and sex-adjusted OR, 3.40; 95% CI, 1.24-9.34). No significant differences were observed in the frequencies of CYP1A1, GSTT1, or TP53 polymorphisms between the two groups. The GSTM1 null genotype was associated with increased GBC risk in Bolivians. Additional studies with larger control and case populations are warranted to confirm the association between the GSTM1 deletion polymorphism and GBC risk suggested in the present study.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.65-71
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• 2016

Although high mammographic density is one of the strongest predictors of breast cancer risk, X-ray based mammography cannot be performed before the recommended screening age, especially not in adolescents and young women. Therefore, new techniques for breast density measurement are of interest. In this pilot study in Guam and Hawaii, we evaluated a radiation-free, bioimpedance device called Electrical Breast Densitometer$^{TM}$ (EBD; senoSENSE Medical Systems, Inc., Ontario, Canada) for measuring breast density in 95 women aged 31-82 years and 41 girls aged 8-18 years. Percent density (PD) was estimated in the women's most recent mammogram using a computer-assisted method. Correlation coefficients and linear regression were applied for statistical analysis. In adult women, mean EBD and PD values of the left and right breasts were $230{\pm}52$ and $226{\pm}50{\Omega}$ and $23.7{\pm}15.1$ and $24.2{\pm}15.2%$, respectively. The EBD measurements were inversely correlated with PD ($r_{Spearman}=-0.52$, p<0.0001); the correlation was stronger in Caucasians ($r_{Spearman}=-0.70$, p<0.0001) than Asians ($r_{Spearman}=-0.54$, p<0.01) and Native Hawaiian/Chamorro/Pacific Islanders ($r_{Spearman}=-0.34$, p=0.06). Using 4 categories of PD (<10, 10-25, 26-50, 51-75%), the respective mean EBD values were $256{\pm}32$, $249{\pm}41$, $202{\pm}46$, and $178{\pm}43{\Omega}$ (p<0.0001). In girls, the mean EBD values in the left and right breast were $148{\pm}40$ and $155{\pm}54{\Omega}$; EBD values decreased from Tanner stages 1 to 4 ($204{\pm}14$, $154{\pm}79$, $136{\pm}43$, and $119{\pm}16{\Omega}$ for stages 1-4, respectively) but were higher at Tanner stage 5 ($165{\pm}30{\Omega}$). With further development, this bioimpedance method may allow for investigations of breast development among adolescent, as well as assessment of breast cancer risk early in life and in populations without access to mammography.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2761-2765
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• 2016

Opisthorchiasis is a health problem in rural communities of Thailand, particularly in the northeast and north regions. Therefore, this study aimed to investigate raw fish consuming behavior related to liver fluke infection among the population at risk for opisthorchiasis and cholangiocarcinoma (CCA). A cross-sectional descriptive study was conducted in Meuang Yang district, Nakhon Ratchasima province, northeast Thailand, between June and October 2015. Participants were screened for CCA, and samples who had a high score of CCA risk were purposively selected. A predesigned questionnaire was utilized to collect the data from all participants. $X^2-test$ was used for analysis of associations between demographic data and raw fish consumption. The results revealed that participants had past histories of stool examination (33.0%), liver fluke infection (21.0%), praziquantel use (24.0%), raw fish consumption (78.0%), relatives family consuming raw fish (73.0%), and relatives family with CCA (3.0%). Participants consumed several dished related to liver fluke infection, mainly raw fermented fish (13.0%), under smoked catfish (5.00%), raw pickled fish (4.00%), and raw spicy minced fish salad (3.00%). The most common types of cyprinoid fish were Barbodes gonionotus (39%), Hampala dispar (38%), Puntius brevis (37%), Cyclocheilichthys armatus (33%), Puntioplites proctozysron (32%), and Luciosoma bleekeri (30%), respectively. Participants had a low level of knowledge (mean=3.79, SD=0.74), moderate attitude (mean=7.31, SD=7.31) and practice (mean=38.64, SD=6.95) regarding liver fluke prevention and control. Demographic variables like age (>36 years old; $X^2-test=17.794$, p-value=0.001), education (primary school; $X^2-test=18.952$, p-value=0.001), marital status (married; $X^2-test=12.399$, p-value=0.002), and income (<5,000 baht; $X^2-test=27.757$, p-value=0.015) were significantly associated with raw fish consumption. This result indicates that the population had risk consumption for liver fluke infection particularly of various cyprinoid fishes that are $2^{nd}$ intermediate hosts. Therefore, health education is required to improve their behavior.

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.12a
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• pp.4-15
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• 2005

Methylmercury (MeHg) is an environmental pollutant with neurotoxic effects on the central nervous system. The major exposure route of MeHg to humans is via consumption of fish and shellfish which accumulate the chemical through the food web in an aquatic environment. Hair mercury level is an excellent marker for MeHg exposure. We have been conducting a survey on hair mercury contents among general populations from 14 districts to estimate the current Japanese MeHg exposure level. Total mercury levels of all hair samples collected (12923 in total) were analyzed by the oxygen combustion-gold amalgamation method using an atomic absorption mercury detector. Multiple regression analysis revealed that mercury levels were significantly correlated with several covariates, such as sex, age, the amount of daily intake of total fish/shellfish, a preference for certain fish such as tuna or bonito, and artificial waving. The geometric means for the population without artificial waving were 2.47 and 1.65 ${\mu}g/g$ for males (n = 5623) and females (n = 3470), respectively. Hair mercury levels varied with age, and the variations were more significant in males. Since the difference between sexes was not evident at younger ages, some hormonal control might also be involved in the mercury uptake by human hair. The average mercury levels in our hair samples varied among the sampling districts. Tuna is a major carnivorous fish with high mercury accumulations that is often consumed in Japan. The amount of fish consumption and the preference rate far tuna would appear to be responsible far the regional variation in hair mercury levels in Japan. Recently, a provisional tolerable weekly intake (PTWI) of MeHg was revised by 61st JECFA to 1.6 ${\mu}g/kg/week$, which was about half that of the Japanese standard, and corresponded to a hair level of 2.2 ppm. The distribution of hair mercury levels in Japanese populations in the present study indicated that 25% of the Japanese females of child-bearing age were estimated to be exposed to MeHg over the PTWI level. This would reflect the high Japanese consumption of marine products. However, not only mercury contamination, but also the nutritional benefit may have to be considered when discussing the risk involved in the current level of fish and shellfish consumption in Japan.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6521-6526
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• 2015

Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

• Biomedical Science Letters
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• v.22 no.2
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• pp.37-45
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• 2016

High risk human papillomavirus (HR-HPV) is major risk factor for uterine cervical cancer. There are approximately 15 types of HR-HPV. Liquid based cytology samples (116 samples) with high grade cervical lesions belonging to cervical intraepithelial neoplasia (CIN) 2, CIN 3, carcinoma in situ (CIS) and squamous cell carcinoma (SCC) were used after histologic confirmation. HR-HPV genotype assay was conducted using DNA chips. The HR-HPV infection rate was 81.9% with SCC samples showing the highest HR-HPV infection rate of 31%. CIN 3, CIS and CIN 2 showed infection rates of 25%, 16.4% and 9.5%, respectively. According to age with HR HPV infection rate, the 30~39 years-old group showed the highest infection rate by 92.3%. According to distribution with HR HPV genotyping, HPV 16 showed the highest infection rate by 42.3% whereas HPV 33 and HPV 58 showed infection rates of 11.7% and 10.8%, respectively. HPV 18 which is the second most common infected HPV genotype in the world showed 3.6%. Of the three most common oncogenic HR-HPV genotypes in CIN 2, we detected HPV 16, 35, 58; CIN 3 was HPV 16, 33, 58; CIS was HPV 16, 58, 33 (35/52); and SCC was HPV 16, 33, and 18 (31/52/58). Among the HPV 18, CIN 2, CIN 3, CIS and SCC showed 0.9%, 0.9%, 0% and 1.8%, respectively. The most often used preventive vaccines for cervical cancers use HPV 16 and HPV 18 as targets. However, results derived from this study suggest that a preventive vaccine against HPV 16 and HPV 18 would not be optimal for populations in this study.