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Sex differences in chronic obstructive pulmonary disease characteristics: the Korea National Health and Nutrition Examination Survey 2007-2018

  • Moon Seong Baek;Haegwang Shin;Kang-Mo Gu;Hae In Jung;Won Young Kim;Jae-Woo Jung;Jong-Wook Shin;Sun-Young Jung;Jae-Yeol Kim
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.137-147
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    • 2024
  • Background/Aims: Chronic obstructive pulmonary disease (COPD) is less prevalent in females than males, but it affects mortality in females. There may be sex differences in the clinical characteristics of COPD. Methods: We analyzed the Korea National Health and Nutrition Examination Survey dataset from 2007 to 2018. We compared the clinical characteristics and comorbidities in subjects with COPD according to sex. We adjusted the multivariate logistic regression of lung cancer prevalence according to COPD and sex by age and smoking amount. Results: Females with COPD tended to be older than males with COPD (64.1 ± 0.4 yr vs. 62.3 ± 0.2 yr, respectively, p < 0.001). Approximately 89% of males with COPD had a smoking history, while 86% of females with COPD were non-smokers (p < 0.001). Household income was lower (p < 0.001) and asthma and overall malignancy were more prevalent in females with COPD than males with COPD (25.5 vs. 11.6%, respectively, p < 0.001; (6.3 vs. 5.4%, respectively, p < 0.001). However, lung cancer was more common in males with COPD than females with COPD (0.9 vs. 0.1%, respectively, p < 0.001). Lung cancer prevalence increased in males with moderate COPD compared to subjects without COPD (OR, 4.409; 95% CI, 1.741-9.419). Conclusions: Females with COPD had a lower smoking rate, household income, and lung cancer prevalence than males with COPD. More active COPD screening is needed for women of low socioeconomic status, even if they do not smoke.

Arthroscopic evaluation of the rotator cuff vasculature: inferences into the pathogenesis of cuff tear and re-tear

  • Steafano Gumina;Hyun Seok Song;Hyungsuk Kim;Vittorio Candela
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.203-211
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    • 2024
  • Background: Little is known about alterations of the rotator cuff (RC) macroscopic vasculature associated with medical conditions and/or habits that predispose a person to diseases of the peripheral microcirculation. The high frequency of cuff tear and re-tear in patients with diabetes, hypercholesterolemia, uncontrolled arterial hypertension, or metabolic syndrome may be due to tissue hypovascularity. Methods: The macroscopic vasculature of both the articular and bursal sides of the posterosuperior RC was evaluated arthroscopically in 107 patients (mean age, 58.2 years) with no RC tear. Patients were divided into three groups according to medical comorbidities and lifestyle factors (group I, none; group II, smokers and/or drinkers and one comorbidity; and group III, two or more comorbidities). Pulsating vessels originating from both the myotendinous and osteotendinous junctions were assessed as "clearly evident," "poorly evident," or "not evident." Results: Groups I, II, and III comprised 36, 45, and 26 patients, respectively. Within the myotendinous junction, vessels were visualized in 22 group I patients (61%), 25 group II patients (55%), and 6 group III patients (23%) (P=0.007). Pulsating arterial vessels originating from the osteotendinous junction were seen in 42%, 36%, and 0% of patients, respectively (P<0.001). Within the bursal side of the RC, a dense anastomotic network was visualized (either clearly or poorly) in 94% (34), 80% (36), and 35% (9) of patients, respectively (P<0.001). Conclusions: The macroscopic vasculature of the RC is influenced by pre-existing diseases and lifestyle factors, which may impair peripheral microcirculation.

Establishment of analytical methods for HPHC list of mainstream cigarette smoke (담배 주류연 중 7개 그룹의 유해성분(HPHC) 분석법 확립 및 유효성 평가)

  • Park, Hyoung-Joon;Lee, Jin-Hee;Cho, So-Hyun;Heo, Seok;Yoon, Chang-yong;Baek, Sun-Young
    • Analytical Science and Technology
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    • v.28 no.6
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    • pp.385-397
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    • 2015
  • Harmful and potentially harmful constituents (HPHCs) are chemical compounds in tobacco smoke that cause harm to smokers and non-smokers. This study established and validated methods for the analysis of HPHCs from mainstream cigarette smoke. The analyzed HPHCs were categorized into seven groups: aromatic amines, volatile organic compounds (VOCs), heavy metals, tobacco specific nitrosamines (TSNAs), benzo[a]pyrene (B[a]P), ammonia, and carbonyl compounds. The methods were validated by specificity, linearity, limit of detection (LOD), accuracy, precision, and recovery. These validated methods were then applied to the reference cigarettes (1R5F, 3R4F). The correlation coefficients (r2) for the calibration curves of the seven groups were over 0.995. The LODs showed values of 0.01-0.04 ng/cig cig for aromatic amines, 0.01-0.16 μg/cig for VOCs, 0.01-1.27 ng/cig for heavy metals, 0.06-0.28 ng/cig for TSNAs, 0.04 ng/cig for benzo[a]pyrene, 0.08 μg/cig for ammonia, and 0.78-1.77 μg/cig for carbonyl compounds. The precisions obtained from the intra and inter-day batches were less than 15%. The accuracy and the recovery range were less than 15% and 79.2-117.5%, respectively. The proposed methods can therefore be applied for determining HPHCs in tobacco mainstream smoke.

A Study on Health Behaviors and Problems of Female Retail Workers (유통업 여성 근로자의 건강 문제와 건강 행위에 관한 연구)

  • Kim, Souk-Young;Yun, Soon-Nyung
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.127-145
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    • 2000
  • The objectives of this study are to identify health behaviors and health problems. and the relations between health behaviors and health problems of female workers in the retail business. The number of subjects were 200 female workers of 6 department stores in Seoul and Kyonggi area, whose jobs last more than 6 months as retail employees. The data was collected during 2 months from July 1 to August 30, 1998. The Cornell Medical Index Health Questionnaire(CMI) was used to measure their health problems, while health behaViorn were investigated in terms of 'smoking', 'alcohol', exercise', 'diet', and 'sleeping'. The data were analyzed with frequency. percentage, t-test, ANOVA test, and $X^2-test$ by SPSS PC+ program. The results of this study are as follows: 1. Out of health problems. Digestive symptoms occupied the highest percent number. nervous ones the second and cardiovascular ones the third among physical health problems of retail female workers. The most frequent mental health problem was 'adequacy' and the next, 'tension' and 'anger', 2, Health problems according to general characteristics of subjects were shown that the younger or the unmarried complained more than the older or the married, especially in the items of 'eye and ear', 'respiratory system', 'cardiovascular system', 'digestive tract', 'nervous system', 'adequacy', and 'depression'. The longer working duration they have had, the more they complained of 'respiratory system' and 'adequacy'. The lower academic careers complained of 'nervous' than the higher ones with statistical significance. 3. The analysis of daily health clinic notes showed that respiratory complaints were the highest percent, successively followed by digestive tract, nervous one, external injury, musculoskeletal system, urinary-reproductive system and others. 4. The level of their health practice was generally low in smoking, diet habit and alcohol intake, exercise, sleeping, very low especially in smoking, diet, alcohol intake, and exercise among them all. 5. Present smokers and ones with past experience complained of physical and mental health problems of 'respiratory system', 'digestive tract', 'skin', 'nervous', 'urinary-reproductive system', 'fatigability', adequacy', 'depression', 'anxiety', 'anger' and 'tension', than non smokers, with statistical difference. Workers without having breakfast and with irregular diet had more complaints on 'digestive tract', 'adequacy' and 'tension', than those who had regular dietary habit. The less the subjects slept, the more they complained of eye and ear, cardiovascular system. The subjects who drank alcohol complained more digestive problem. However, whether they exercise or not did not affect physical and mental health problems in a significant manner. 6. The subjects' age and marital status were statistically significant relating to health behaviors, as the younger or unmarried recorded a low level of health practice in smoking, drinking, dietary habit. Based on the results, the suggestions are made as follows: 1. Health education program on smoking, alcohol intake, diet habit is needed to improve health problems and health behavior of female retail workers. 2. The unmarried workers of late teen and twenties, who are transitional period from teenagers to adulthood are important targets for health promotion program especially for maternal health. 3. Better working environment with sufficient time and facilities for workers to relax is required to promote female sales workers' health. 4. Further research is required to identify the relation between workers' visual fatigue and intense lights for the display of goods.

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The Clinical Analysis of Primary Lung Cancer: A Hospital-based Study (원발성 폐암의 임상분석)

  • Kim, Yeon-Su;Kim, Gwang-Taek;Kim, Han-Gyeom;Kim, Hak-Jae
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.308-314
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    • 1997
  • A retrospective review of the histopathology and clinical information of primary lung cancer was performed to investigate the trends in the histologic type related to sex, age, and smoking history. During January 1988 and July 1995, 541 pateints were diagnosed as primary lung cancer at the Korea Univeristy Anam Hospital. Male (423) to female(118) ratio was 3. 6:1. The most frequent histologic type of lung cancer in male patients was squamous cell carcinoma (223 patients, 52.7%) followed by adenocarcinoma (86, 20.3%) and small cell carcinoma (85, 20.1 %). In female patients, adenocarcinoma (64, 54.2%) wa most common, which was followed by squamous cell carcinoma (22, 18.6%) and small cell carcinoma (22, 18. 6%). The incidence of adenocarnimoma had an increased tendency recently (14.3% in 1988, 33.3% in 1995)(P=0.019). The predominant type in smokers was squamous cell carcinoma; whereas adenocarcinoma was the most frequent type in non-smokers. The proportion of patients aged less than 40 years (younger group) was 4. 0% (n=22). Of them, adenocarcinoma (7) and small cell carcinoma (7) were most common. In patients older than 40 years (older group, n=519), 243 (46.8%) patients had squamous cell carcinoma, and 143 (27.6%) adenocarcinoma. As age increased, the prevalence of squamous cell carcinoma was increased (P=0.0005), adenocarcinoma decreased (P=NS), and small cell carcinoma remained unchanged. We suggest above data as a clinical guidance for management of primary lung cancer.

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Effect of Orthodontics Patients' Orthodontics Characteristics on the Living Quality Related to Oral Health (OHIP) (교정환자의 교정치료 특징이 구강건강관련 삶의 질(OHIP)에 미치는 영향)

  • Yoon, Sung-Uk;Oh, Na-Rae;Jeong, Mi-Ae
    • The Journal of the Korea Contents Association
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    • v.14 no.3
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    • pp.250-258
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    • 2014
  • The purpose of this study was to promote effective health management of orthodontics patients by determining the effect that the factors related to orthodontics would have on the Oral Health Impact Profile (OHIP), and the subjects of this study was the local residents of Gangwon-do Province. The mean score of OHIP for the subjects was 2.97, while the mean score of physical factor was 3.01. The mean score of psychological factor was found to be 2.93. Thus, the orthodontics was found to have more influence on psychological factor. The item that had the greatest influence among the 10 items of Oral Health Impact Profile was found to be the question, "Have you ever felt shy due to your dental shape?" which had the mean score of 2.66. The characteristics that had significant effect on OHIP among general characteristics were found to be the age, religion, occupation, income, smoking or non-smoking status(p<0.05). In terms of the age, the age of 20 or less had the greatest effect with the mean score of 2.53. In relation to the occupation, the production/sales occupation had an influence with the mean score of 2.56 (p<0.05). Those with income exceeding KRW 4 million were found to have the mean score of 2.83 and 2.78. It turned out that the smokers had greater effect compared to the non-smokers in relation to the smoking/non-smoking status as the income was higher (p<0.05). The characteristics of orthodontics were manifested as the health perception in relation to Oral Health Impact Profile (OHIP) (p<0.05). Regarding the reason why they underwent the orthodontics, the 'uncomfortable feeling in chewing' was found to have the mean score of 2.69 and 2.67 (p<0.05). Regarding the orthodontics period, 1 to 2 years were found to have the mean score of 2.80 and 2.74, thus having an influence (p<0.05). In relation to the regret/non-regret over orthodontics, those who indicated that they regretted were found to have the mean score of 2.65 and 2.60 (p<0.05). Analysis of the relationship between Characteristics of orthodontic treatment and OHIP, orthodontic treatment reasons, oral health awareness, whether orthodontic treatment regret showed a statistically significant correlation. it is considered necessary to make constant efforts to help orthodontics patients, both physically and psychologically, in the course of treatment and improve their quality of lives.

Association between the Number of Existing Permanent Teeth and Chronic Obstructive Pulmonary Disease (현존자연치아수와 만성폐쇄성폐질환과의 연관성)

  • Shin, Hye-Sun;Ahn, Yong-Soon;Lim, Do-Seon
    • Journal of dental hygiene science
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    • v.16 no.3
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    • pp.217-224
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    • 2016
  • The aim of this study was to evaluate whether the number of existing permanent teeth is associated with chronic obstructive pulmonary disease (COPD) in a representative sample of Korean adults. Data from 3,107 subjects who participated in the 2009 Korea National Health and Nutrition Examination Survey were examined. The dependent variable was COPD and the independent variable was the number of existing permanent teeth. Spirometry results were classified into three groups (normal pattern, restrictive pattern, and obstructive pattern) by trained technicians. We used dichotomized COPD variables (no vs. yes). The number of existing permanent teeth was evaluated by oral examination and divided into 3 groups (0~19, 20~27, and 28). Demographic factors (age group and sex group), socioeconomic status (education and income), health behaviors (smoking and drinking), oral health and behavior (frequency of toothbrushing; periodontitis; decayed, missing, filled, permanent teeth index; and denture status), and general health status (body mass index, diabetes mellitus, and hypertension) were included as confounders in the analysis. Bivariate analysis and multivariate logistic regression analyses including confounders were applied, and all analyses considered a complex sampling design. Stratified analysis was performed by smoking status. After controlling for various confounders, there was a significant association between the number of existing permanent teeth and COPD (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.20~3.00 for the 20~27 group; OR, 3.93; 95% CI, 1.75~8.84 for the 0~19 group). The association was more significant in current smokers (OR, 8.90; 95% CI, 2.53~31.33). Our data indicate that the number of existing permanent teeth was independently associated with COPD, especially in current smokers. Further longitudinal research is needed to determine whether oral health promotion plays a role in the improvement of lung function and prevention of COPD.

The Differences of the Smoking Habit Between Emphysema and Chronic Bronchitis (폐기종과 만성기관지염의 흡연습관 차이)

  • Mun, Yeung-Chul;Yu, Sung-Keun;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Jung-Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.693-703
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    • 2001
  • Background : Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyond just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD according to patient's smoking habits. Method : To evaluate the differences in the smoking patterns of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). Result : The patients with emphysema smoked earlier and had a higher smoking history(ie, more packyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of inhalation was also significantly higher in the emphysema patients after taking into account age, cumulative cigarette consumption and the type of cigarette smoked. Conclusion : Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.

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Determinants of Nicotine Dependence in Chronic Obstructive Pulmonary Disease

  • Sim, Yun Su;Lee, Jin Hwa;Kim, Ki Uk;Ra, Seung Won;Park, Hye Yun;Lee, Chang-Hoon;Kim, Deog Kyeom;Shin, Kyeong-Cheol;Lee, Sang Haak;Hwang, Hun Gyu;Ahn, Joong Hyun;Park, Yong Bum;Kim, Yu-Il;Yoo, Kwang Ha;Jeong, Ina;Oh, Yeon-Mok;Lee, Sang-Do;KOLD Investigators
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.277-283
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    • 2017
  • Background: Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. Methods: We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. Results: The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036-1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376-29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388-34.998; p=0.018) were related to moderate to high nicotine dependence. Conclusion: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.

Research about influence on the teeth health by the smoking - research intended for students of dental technology in Daegu - (흡연이 치아건강에 미치는 영향에 관한 연구 - 대구지역 치기공과 학생을 중심으로 -)

  • Kim, Jeong-Sook;Jung, Hyo-Kyung;Lee, Jong-Do
    • Journal of Technologic Dentistry
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    • v.31 no.3
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    • pp.35-45
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    • 2009
  • This survey study was conducted on dental technician school students in April 2008 to investigate the effects of smoking on oral health. 110 male and 39 female students were surveyed and cross analysis was performed to examine the relationship between oral health status and smoking-related and oral health maintenance characteristics of smoking and non-smoking group. T-test and one-way ANAVA was used to analyze the average difference verification of two independent samples(smoking group and non-smoking group) and followings are the results. In general characteristics, 74 male students(74.7%) and 25 female(25.3%) students smoked and the percentage of male students were higher in smoking group. Regarding class grade, 2nd-year students(37 students, 37.4%) and 1st-year students(18 students, 36.0%) took the highest percentage of smoking and non-smoking group, respectively. Concerning the experience of drinking, smoking group consumed more alcoholic beverages(94 students, 94.9%) With respect to the frequency of between-meal consumption, respondents who eat between-meal once or twice smoked more. Respecting preferences of sweet food, respondents who enjoyed sweet food smoked more. Concerning smoking characteristics, many of smoking group had been smoked fo a long time(two to five years) and it was worrisome. About the amounts of smoking, 50 respondents(52.6%) of smoking group smoked 20 cigarettes a day with the highest proportion. With regard to the awareness of harmfulness, 70 respondents(70.7%) considered smoking as very harmful and showed that smoking group were aware of its harmfulness but it was habitualized. Respecting smokers in family members, father was more common as smokers(58 respondents, 58.6%) in family and showed that the influence of father. Main reasons of poor periodontal health were alchoholic consumption, smoking, and oral parafunctional habit(57 respondents, 56.7%) in smoking group and neglect of oral hygiene(21 respondents, 42.0%) in non-smoking group. With regard to the scaling, 80 respondents of smoking group(80.8%) didn't received scaling and showed that more oral health education was required. Regarding the periodontal status, non-smoking group was $1.26{\pm}0.44$, respondents who received scaling was $1.43{\pm}0.50$, respondents who regularly floss was $1.50{\pm}0.52$, respondents who brush more than three times a day was $1.38{\pm}0.49$ and had better periodontal health. Bleeding during tooth brushing was more frequent in smoking group ($1.51{\pm}0.70$). Regarding mouth order, non-smoking group was $2.34{\pm}0.62$, after scaling was $2.02{\pm}0.76$, patients who regularly floss was $1.50{\pm}0.52$, patients who brush more than three times a day was $1.81{\pm}0.87$. Concerning the experience of dental caries treatment, smoking group was $1.20{\pm}0.40$, patients who do not floss was $1.30{\pm}0.46$, patients who brush once a day was $1.29{\pm}0.45$. With regard to dental prosthesis, non-smoking group was $3.78{\pm}1.62$, patients who received scaling was $1.43{\pm}0.50$, patients who regularly floss was $1.40{\pm}0.51$, patients who brush more than three times a day was $1.24{\pm}0.43$. From these results, oral health education and smoking has correlation and more oral health education needs to be carried out to educate students with non-health related majors about harmfulness of smoking on oral health. Also more study are required.

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