• Safety and Health at Work
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• 제2권3호
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• pp.243-249
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• 2011

Objectives: Cement contains hexavalent chromium, which is a human carcinogen. However, its effect on cancer seems inconclusive in epidemiologic studies. The aim of this retrospective cohort study was to elucidate the association between dust exposure in the cement industry and cancer occurrence. Methods: The cohorts consisted of male workers in 6 Portland cement factories in Korea. Study subjects were classified into five groups by job: quarry, production, maintenance, laboratory, and office work. Cancer mortality and incidence in workers were observed from 1992 to 2007 and 1997-2005, respectively. Standardized mortality ratios and standardized incidence ratios were calculated according to the five job classifications. Results: There was an increased standardized incidence ratio for stomach cancer of 1.56 (27/17.36, 95% confidence interval: 1.02-2.26) in production workers. The standardized mortality ratio for lung cancer increased in production workers. However, was not statistically significant. Conclusion: Our result suggests a potential association between cement exposure and stomach cancer. Hexavalent chromium contained in cement might be a causative carcinogen.

• 한국환경생태학회지
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• 제29권1호
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• pp.7-13
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• 2015

To examine the relationship between competition and environmental factors, the germlings of Ascophyllum nodosum (L) Le Jolis and Fucus vesiculosus L. were cultured in monocultures and mixtures of the two species under two different exposure and nutrient levels. Both intra- and inter-specific competition were examined in comparison of the mortality and growth of germlings in monocultures and mixtures of the two species. The mortality of germlings increased with increasing density and emergence periods both in the monoculture and mixtures of the two species, and the mortality of Ascophyllum was significantly higher than that of Fucus both in submerged and emerged treatments. The growth of germlings of both species reduced with increasing density but F. vesiculosus always grew faster than Ascophyllum. The values of log output ratio were more than 0.1, indicating that Fucus 'won' in the competitive battles with Ascophyllum under two nutrient- and air-exposure levels. Log output ratio was greater in high than in low nutrients, indicating that the growth of Fucus is more enhanced than that of Ascophyllum in high nutrients. In the present study, the outcome of inter specific competition between germlings of Fucus vesiculosus and Ascophyllum nodosum was slightly altered by duration of emergence and nutrient concentration, but not to such an extent as to change the outcome.

• 한국인구학
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• 제26권2호
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• pp.33-62
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• 2003

이 연구의 목적은 사망수준의 저하에 영향을 미치는 세 요소-사회경제적 발전, 공공 보건의 발달, 사회경제적 발달의 균등상태-의 상대적 중요성을 분석하는 것이다. 종속변수인 사망 수준의 지표로는 영아사망률과 출생시 기대수명 등 두 변수가 사용되었다. 국민총생산(GNP)은 사회 경제적 발달지표로 여성의 초등학교 취학률과 기니계수(GINI index)는 사회경제적 균등상태 지표로 병원침대당 인구수는 공공보건 지표로 간주되었다. 변수들에 대한 자료는 두 시점에 걸쳐 수집되었다. 하나는 1970년 이전 53개국에서. 다른 하나는 1970-80년대 55개국에서 수집되었다. 탐색적 자료 분석 방법이 통계 분석 방법으로 사용되었다. 이 기법은 종속변수와 독립변수와의 관계가 선형인지 아닌지, 그리고 우리 모형에서 어느 것이 유력 사례인지를 파악할 수 있는 장점이 있다. 분석결과에 따르면, 첫째로 영아 사망률과 세 요소의 관계가 선형이 아니라 비선형임이 밝혀졌다. 영아 사망률 저하에 국민총생산이 가장 많이, 여성의 초등학교 취학률이 두 번째, 기니계수가 그 다음으로 영향을 미치는 것으로 나타났다. 반면 병원침대당 인구수는 통계적으로 유의미한 영향을 보여주지 않았다. 둘째, 출생시 기대수명은 여성의 취학률, 기니계수 등과 같은 변수와는 선형 관계를 가지는 반면 국민총생산 변수와는 비선형 관계를 가진다. 영아사망률 변수와는 달리 출생시 기대수명의 변이에는 여성의 초등학교 취학률이 국민총생산보다 더 커다란 영향을 미쳤다.

• 보건행정학회지
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• 제27권2호
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• pp.114-120
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• 2017

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1201-1206
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• 2015

Background: Tobacco is consumed in both smoking and smokeless forms in India. About 35-40% of tobacco consumption in India is in the latter. The study objective was to describe the association between chewing tobacco and adult mortality. Materials and Methods: A case-control study was conducted in urban (Chennai city) and rural (Villupuram district) areas in Tamil Nadu state in South India. Interviewed in 1998-2000 about 80,000 families (48,000 urban and 32,000 rural) with members who had died during 1995-1998. These were the cases and their probable underlying cause of death was arrived at by verbal autopsy. Controls were 600,000 (500,000 urban, 100,000 rural) individuals from a survey conducted during 1998-2001 in the same two study areas from where cases were included. Results: Mortality analyses were restricted to non-smoking non-drinkers aged 35-69. The age, sex, education and study area adjusted mortality odds ratio was 30% higher (RR:1.3, 95%CI:1.2-1.4) in ever tobacco chewers compared to never chewers and was significant for deaths from respiratory diseases combined (RR:1.5, 95%CI:1.4-1.7), respiratory tuberculosis (RR:1.7, 95%CI:1.5-1.9), cancers all sites combined (RR:1.5, 95%CI:1.4-1.7) and stroke (RR:1.4, 95%CI:1.2-1.6). Of the cancers, the adjusted mortality odds ratio was significant for upper aero-digestive, stomach and cervical cancers. Chewing tobacco caused 7.1% of deaths from all medical causes. Conclusions: The present study is the first large study in India analysing non-smoking non-drinkers. Statistically significant excess risks were found among ever tobacco chewers for respiratory diseases combined, respiratory tuberculosis, stroke and cancer (all sites combined) compared to never tobacco chewers.

• 디지털융복합연구
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• 제16권10호
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• pp.343-350
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• 2018

본 연구의 목적은 한국 지역사회 거주 노인의 영양상태가 사망위험에 영향을 미치는지 파악하기 위함이다. 본 연구에서는 2008년도 노인실태조사 참여자 8,532명의 자료와 2011년 사망자 자료를 분석하였다. 콕스 회귀 분석 결과, 남성(Hazard Ratio [HR], 2.03; 95% Confidence Interval [CI], 1.74~2.37), 당뇨 (HR, 1.35; 95% CI, 1.12~1.64), 저체중 (HR, 2.68; 95% CI, 2.16~3.31), 연하곤란 (HR, 1.23; 95% CI, 1.02~1.47), 씹기 능력 (HR, 1.33; 95% CI, 1.11~1.59), 영양불량 (HR, 1.47; 95% CI, 1.23~1.75)이 사망위험에 영향을 주는 것으로 나타났다. 한국 노인의 사망위험을 줄이기 위해 체계적인 영양 지원프로그램을 개발해야 할 것이다.

• 대한응급의학회지
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• 제29권5호
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• pp.474-484
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• 2018

Objective: The time to positivity (TTP) of blood culture reflects bacterial load and has been reported to be associated with outcome in bloodstream infections. This study was performed to evaluate the relationship between the TTP of blood culture and the mortality rates associated with sepsis and septic shock according to the site of infection. Methods: We performed a retrospective cohort study on patients with sepsis and septic shock. The rates of blood culture positivity and mortality as well as the relationship between the TTP and 28-day mortality rate were compared among patients with different sites of infection, such as the lungs, abdomen, urogenital tract, and other sites. Results: A total of 2,668 patients were included, and the overall mortality rate was 21.6%. The rates of blood culture positivity and mortality were different among the different infection sites. There was no relationship between the TTP and mortality rates of total, lung, and urogenital infections. Patients with abdominal infections showed a negative correlation between the TTP and 28-day mortality rate. In patients with abdominal infections, a TTP<20 hours was independently associated with 28-day mortality compared with patients with negative blood culture (hazard ratio, 1.73; 95% confidence interval, 1.16-2.58). However, there was no difference in mortality rates of patients with a $TTP{\geq}20$ hours and a negative blood culture. Conclusion: The shorter TTP in patients with abdominal infections in sepsis and septic shock was associated with a higher 28-day mortality rate.

• Journal of Chest Surgery
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• 제17권4호
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• pp.644-656
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• 1984

In Tetralogy of Fallot, the most common congenital cyanotic heart disease, the mortality is decreasing continuously with adequate type and timing of operation. At S.N.U.H., 195 patients were operated from January 1982 to December 1983 and 176 patients among them were analysed in the view of pre-operative pulmonary arterial condition measured by cardiac cineangiogram. The most common associated anomaly was PFO and ASD and they did not affect the postoperative course and mortality. The overall mortality rate was 8.5% in 1982 and 6.8% in 1983 but under 2 years of age, the mortality rate was relatively high as 25% in 1982 and 16.7% in 1983, and when transannular patch widening of Right Ventricular Outflow Tract was used, the mortality rate was 12.5% in 1982 and 27.3% in 1983. Preoperative angiographic measurements of the pulmonary arterial status for prediction of the ratio between the Left Ventricular and Right Ventricular peak systolic pressure were calculated retrospectively according to the Blackstones formula, and the predicted value of PRV/LV greater than 0.6 carried apparently high complication and mortality rate as 16.6% M.R. in 1982 and 11.1 % in 1983. Among postoperative complications, c-RBBB occurred most frequently about 50% but did not influenced to mortality, Low Cardiac Output Syndrome was developed in about 40%. If we select the patient who should have the staged operation including shunt operation and choose the type of RVOT relief, we expect the improvement of postoperative clinical results.

• 한국임상수의학회지
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• 제34권2호
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• pp.82-86
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• 2017

We determined the risk factors for late embryonic mortality in dairy cows. We diagnosed pregnancy at 31 days and then confirmed the diagnosis at 45 days after artificial insemination (AI) via ultrasonography. The presence of an embryo with a heartbeat was the criterion for a positive pregnancy diagnosis. A diagnosis of late embryonic mortality was made when there was no positive sign of pregnancy in cows previously diagnosed as pregnant. The overall incidence of late embryonic mortality among 3,695 pregnancies was 6.9%. Logistic regression analysis revealed that herd size, AI month, synchronization protocol, and postpartum disease were important risk factors for late embryonic mortality. Herd size > 100 (odds ratio [OR]: 0.66, p < 0.05) and 50-100 lactating cows (OR: 0.63, p < 0.01) had lower risks of late embryonic mortality than herd size < 50 lactating cows. Cows inseminated during May-July had a higher risk (OR: 1.49, p < 0.05) of late embryonic mortality than cows inseminated during February-April. Cows inseminated after estrus following $PGF_{2{\alpha}}$ treatment also had a higher risk (OR: 1.77, p < 0.001) of late embryonic mortality than cows inseminated following natural estrus. Lastly, cows with postpartum disease tended to have a higher risk (OR: 1.26, p < 0.1) of late embryonic mortality than cows without postpartum disease. In conclusion, late embryonic mortality associated with the herd size, AI month, synchronization protocol, and postpartum disease in dairy cows.

• 농촌의학ㆍ지역보건
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• 제32권1호
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• pp.13-26
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• 2007

Objectives: This study was conducted to investigate the association between health risk factors and mortality in Juam cohort. Methods: The subjects were 1,447 males and 1,889 females who had been followed up for 68.5 months to 1 January 2001. Whether they were alive or not was confirmed by the mortality data of the National Statistical Office. A total of 289 persons among them died during the follow-up period. The Cox's proportional hazard regression model was used for survival analysis. Results: Age, type of medical insurance, self cognitive health level, habit of alcohol drinking, smoking, exercise and BMI level were included in Cox's proportional hazard model by gender. The hazard ratio of age was 1.07(95% CI: 1.05-1.10) in men, 1.09(95% CI: 1.06-1.12) in women. The hazard ratio of medical aid(lower socioeconomic state) was 1.43(95% CI 1.02-2.19) in women. The hazard ratios of current alcohol drinking and current smoking were respectively 1.69(95% CI: 1.01-2.98), 1.52(95% CI: 1.02-2.28) in women. The hazard ratio of underweight was 1.56(95% CI 1.08-2.47) in men. The hazard ratios of underweight, normoweight, overweight, and obesity were respectively 1.63(95% CI: 1.02-2.67), 1.0(referent), 0.62(95% CI: 0.32-1.63), 1.27(95% CI: 0.65-3.06), which supported the U-shaped relationship between body mass index and mortality among the men over 65. Conclusions: The health risk factors increasing mortality were age, underweight in male, age, lower socioeconomic state, current alcohol drinking, current smoking in female. To evaluate long-term association between health risk factors and mortality, further studies need to be carried out.