Recently, a series of lawsuits were filed in Korea claiming tort liability against tobacco companies. The Supreme Court has already issued decisions in some cases, while others are still pending. The primary issue in these cases is whether the epidemiological evidence submitted by the plaintiffs clearly proves the causal relationship between smoking and disease as required by civil law. Proving causation is difficult in tobacco lawsuits because factors other than smoking are involved in the development of a disease, and also because of the lapse of time between smoking and the manifestation of the disease. The Supreme Court (Supreme Court Decision, 2011Da22092, April 10, 2014) has imposed some limitations on using epidemiological evidence to prove causation in tobacco lawsuits filed by smokers and their family members, but these limitations should be reconsidered. First, the Court stated that a disease can be categorized as specific or non-specific, and for each disease type, causation can be proven by different types of evidence. However, the concept of specific diseases is not compatible with multifactor theory, which is generally accepted in the field of public health. Second, when the epidemiological association between the disease and the risk factor is proven to be significant, imposing additional burdens of proof on the plaintiff may considerably limit the plaintiff's right to recovery, but the Court required the plaintiffs to provide additional information such as health condition and lifestyle. Third, the Supreme Court is not giving greater weight to the evidential value of epidemiological study results because the Court focuses on the fact that these studies were group-level, not individual-level. However, group-level studies could still offer valuable information about individual members of the group, e.g., probability of causation.
Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.11
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pp.498-508
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2017
Purpose: The present study investigated nutrient supplement intake to examine the relationship between the health behaviors of nutrient supplement users and nonusers and nutrient supplement users and other drug users. The results provide baseline data to understand whether nutrient supplements actually perform as expected in view of the fact that healthy people that take nutritional supplements may become healthier, but may also develop nutritional supplement abuse problems. Among 7,006 household heads of 24,614 household members from the Korea Health Panel data in 2008, a total of 6,009 household heads were the respondents of the Korea Health Panel Survey (appendix) in 2009. Method: The subjects of the present study were targeted household heads. The respondents who reported that they had taken (planned to take) life/health promotion-related drugs (01. vitamins/nutritional supplements) for more than three months that were purchased at pharmacies during the past one year at the time of the survey were defined as nutritional supplement users. Those who took other drugs (05. hair-loss treatments, 06. obesity treatments, 10. others) were regarded as other drug users. A chi-squared test was performed to analyze the sociodemographic characteristics of the subjects and differences between groups. Multiple regression analyses were conducted to analyze health behaviors according to nutrient supplement intake. Result: Comparison of (A) nutritional supplement users and nonusers revealed that those who were women, 50 years or older, and spent more than average living expenses were more likely to take nutritional supplements, which was not significant in health behavior variables. Analysis of nutritional supplement users and other drug users (B) revealed that those who were high school graduates or above, had a spouse, were non-smokers, took drugs, ate regular meals, and were not stressed by economic or family conflicts were more likely to take nutritional supplements. Conclusion: The results of the present study indicated that people take nutritional supplements because of their psychological desire to be healthy, not because they are not healthy, have problems, or believe supplements will make them healthier.
There is a growing concern about potential harmful effect of second-hand or environmental tobacco smoking. As a result, smoking bans in workplace become more prevalent worldwide. In Korea, workplace smoking ban policy become more restrictive in 2003 when National health enhancing law was amended. The new law requires all office buildings larger than 3,000 square meters (multi-purpose buildings larger than 2,000 square meters) should be smoke free. Therefore, a lot of indoor office became non smoking area. Previous studies in other counties often found contradicting answers for the effects of workplace smoking ban on smoking behavior. In addition, there was no study in Korea yet that examines the causal impacts of smoking ban on smoking behavior. The situation in Korea might be different from other countries. Using 2001 and 2005 Korea National Health and Nutrition surveys which are representative for population in Korea we try to examine the impacts of law change on current smoker and cigarettes smoked per day. The amended law impacted the whole country at the same time and there was a declining trend in smoking rate even before the legislation update. So, the challenge here is to tease out the true impact only. We compare indoor working occupations which are constrained by the law change with outdoor working occupations which are less impacted. Since the data has been collected before (2001) and after (2005) the law change for treated (indoor working occupations) and control (outdoor working occupations) groups we will use difference in difference method. We restrict our sample to working age (between 20 and 65) since these are the relevant population by the workplace smoking ban policy. We also restrict the sample to indoor occupations (executive or administrative and administrative support) and outdoor occupations (sales and low skilled worker) after dropping unemployed and someone working for military since it is not clear whether these occupations are treated group or control group. This classification was supported when we examined the answers for workplace smoking ban policy existing only in 2005 survey. Sixty eight percent of indoor occupations reported having an office smoking ban policy compared to forty percent of outdoor occupation answering workplace smoking ban policy. The estimated impacts on current smoker are 4.1 percentage point decline and cigarettes per day show statistically significant decline of 2.5 cigarettes per day. Taking into account consumption of average sixteen cigarettes per day among smokers it is sixteen percent decline in smoking rate which is substantial. We tested robustness using the same sample across two surveys and also using tobit model. Our results are robust against both concerns. It is possible that our measure of treated and control group have measurement error which will lead to attenuation bias. However, we are finding statistically significant impacts which might be a lower bound of the true estimates. The magnitude of our finding is not much different from previous finding of significant impacts. For cigarettes per day previous estimates varied from 1.37 to 3.9 and for current smoker it showed between 1%p and 7.8%p.
Song, Jung Sub;Kim, So Young;Jo, Hyang Jeong;Lee, Kang Kyoo;Shin, Jeong Hyun;Shin, Seong Nam;Kim, Dong;Park, Seong Hoon;Lee, Young Jin;Ko, Chang Bo;Lee, Mi Kung;Choi, Soon Ho;Jeong, Jong Hoon;Park, Jung Hyun;Kim, Hui Jung;Kim, Hak Ryul;Jeong, Eun Taik;Yang, Sei Hoon
Tuberculosis and Respiratory Diseases
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v.66
no.6
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pp.444-450
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2009
Background: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. Methods: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. Results: The mean plasma G-CSF levels were 12.2$\pm$0.3 pg/mL and 46.0$\pm$3.8 pg/mL (mean$\pm$SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II
Ruggeri, Joao Batista;Agnolo, Catia Millene Dell;Gravena, Angela Andreia Franca;Demitto, Marcela de Oliveira;Lopes, Tiara Cristina Romeiro;Delatorre, Silvana;Carvalho, Maria Dalva de Barros;Consolaro, Marcia Edilaine Lopes;Pelloso, Sandra Marisa
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.
Background : Coughing is the most common complaint for which patients seek medical service. When caughing continues over 3 weeks in non-smokers who do not take cough-provoking drugs, they are classified as patients with chronic cough. Three well known main causes of chronic caugh are postnasal drip syndrome, bronchial asthma and gastroesophaseal reflux disease. Among them, postnasal drip syndrome is reported to be the most common cause of all in chronic cough diseases, and allergic inflammation plays an important role in the pathogenesis of postnasal drip syndrome. CD23 and CD25 which are low affinity receptor for IgE and IL-2 receptor alpha, respectively, are closely related to allergic inflammation and their roles were evaluated in chronic cough patients. Methods : We evaluated 105 patients with chronic cough and selected 56 patients for measurement of serum CD23 & CD25 levels. We selected 10 normal, medical students for comparison of serum CD23 & CD25 levels. Result : The postnasal drip syndrome was found to be the most common cause of chronic cough. Serum CD23 and CD25 did not increase in chronic cough patient compared to normal controls. However in bronchial asthma patient, serum CD23 level was increased relative to normal control (p<0.05). Conclusion : In bronchial asthma presented as chronic cough, lymphocyte mediated allergic inflammation may related with the pathogenesis of the disease.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.11
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pp.403-410
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2018
This study is to look at the risk of chronic diseases in adults and oral health behaviors affecting periodontitis by gender. This study selected 3,071 males aged 35 to 65, 4,273 females, and 7,344 people as the final subjects of the study using the sixth original data from the National Health and Nutrition Survey. In this study, subjective oral health classified under 'bad' presented 1.69 times(p<0.001) the risk of Periodontitis for males and 1.50 times(p<0.001) for females. There was a 2.01 times(p<0.001) of a risk of periodontitis for male and 1.40 times(p=0.001) of a risk for females. Smokers have a 1.68 times(p<0.001) of a risk for males and 2.07 times(p<0.001) of a risk for females, thus a higher risk for periodontitis for females. The risk of periodontitis was 1.44 times(p<0.001) of a risk for males and 1.30 times(p<0.05) for females when compared in normal hypertension. Obesity was at a rate of 1.199 times(p<0.05) as much for males in the non-military group, 1.202 times(p<0.05) that of females for periodontitis and putting females slightly more at risk. For diabetes, males were at risk of 1.28(p<0.05) whereas it being 1.53 times(p<0.05) for females, compared the average health female. In total, Males were found to be at the greatest risk of periodontitis, while women were at the highest risk for smoking. All parameters except smoking and diabetes show a higher risk of periodontitis for females. As males are more likely to have a higher risk of periodontitis than females, they are considered to be more interested in oral health care and need systematic oral health education and policies to prevent oral diseases.
Purpose: This study aimed to investigate the perceptions of the dietary guidelines for Koreans (DGK) among Korean adults based on sociodemographic and lifestyle factors. Methods: A total of 514 Korean adults aged 19-64 years completed a self-administered online questionnaire assessing their perceptions of DGK, sociodemographic and lifestyle factors, and subjective assessments regarding the importance of 11 nutrients and 16 food groups. The differences in the perceptions of DGK according to the characteristics of the participants were analyzed using t-tests or ANOVA. Additionally, the differences in the subjective assessments of nutrients and food groups according to the perceptions of DGK were examined using t-tests. Results: The awareness of DGK was significantly higher among participants aged 50-64 years, living in single-person households, who were physically active, with a lower frequency of eating out, and with a higher interest in dietary information (p < 0.05 for all). The understanding of DGK was significantly higher among participants aged 19-29 years, females, individuals who were under or normal weight, non-smokers, those who self-evaluated their diet as healthy, and those with a high interest in dietary information (p < 0.05 for all). Additionally, the applicability of DGK was significantly higher among participants aged 50-64 years, who were physically active, who self-evaluated their diet as healthy, and who had a high interest in dietary information (p < 0.05 for all). Participants with a higher perception of DGK tended to attribute greater importance to most nutrients and food groups compared to those with a lower perception level. However, processed meat and foods, beverages, and alcoholic drinks consistently received lower importance ratings compared to other nutrients and food groups, regardless of the perception level. Conclusion: This research suggests that the perceptions of DGK among Korean adults may vary depending on sociodemographic and lifestyle factors. Consequently, there is a need to customize and diversify the methods for providing dietary guidelines.
Kim, Young-Sam;Ahn, Ae-Ran;Kim, Se-Kyu;Chang, Joon;Ahn, Chul-Min;Oh, Jai-Joon;Kim, Sung-Kyu
Tuberculosis and Respiratory Diseases
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v.50
no.3
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pp.320-333
/
2001
Background : Peak expiratory flow (PEF) provides a simple, quantitative, and reproducible measure of the existence and severity of airflow obstructions. Peak flow meters are designed to monitor the condition asthma patients. There are many reports showing the normal predicted value of PEF in other countries. Studies on healthy Korean adults have been performed in a relatively small sample number and a lower limit for the normal value was not reported. Therefore, an attempt to provide normal predictive PEF value with a lower limit was made. Method : The PEF(Mini-Wright Peak Flow Meter) measurements and spirometry were done in 233 men and 631 women without history of respiratory disease. All subjects were non-smokers with no respiratory symptoms. The normal predictive value and its lower limit were developed by multiple regression analysis. The result was compared with regression equations in other reports. Results : The regression equation for the normal PEF predictive value(L/min) is $25.117+4.587{\times}$Age(year)-$0.064{\times}Age^2+2.931{\times}$Height(cm) in men($R^2=025$), and 146.942-$0.011{\times}Age^2+1.795{\times}$Height(cm)+$0.836{\times}$Weight(kg) in women($R^2=0.21$). The regression equation for the lower limit of this value (L/min) is $25.117+4.587{\times}$Age(year)-$0.064{\times}Age^2+1.936{\times}$Height(cm) in men, and $146.942-0.011{\times}Age^2+1.232{\times}$Height(cm)+$0.481{\times}$Weight(kg) in women. The residuals were normally distributed. The PEF in Korean males was sililar to those reported in British and Japanese subjects. The PEF in Korean females was similar to that in British subjects, but higher than the PEF in Japanese subjects. The lower limit of normal value was 71% of normal predictive PEF value in men and 76% in women. Conclusion : The normal predictive PEF value and its lower limit was measured from 233 male and 631 female asymptomatic, lifelong non-smoking participants. The normal predictive value was different from those of other studies on Korean subjects. Therefore, further studies are required.
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