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The Risk of Onset of the Illnesses Based on Gender, Age, and Monthly Income;Focusing on cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders (성별, 연령별, 월소득차이에 따른 질병발생의 위험성 차이연구;암, 고혈압, 중풍, 당뇨병, 관절염, 심장병을 중심으로)

  • Lee, Jun-Oh;Kim, Se-Jin;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.1
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    • pp.19-48
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    • 2008
  • In order to verify the risk of onset of the illnesses based on gender, age, and monthly income 1,739 subjects from Hongcheon county, Gangwon province were selected. Questionnaire on demographic sociology, health condition, existence of illnesses(cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders), and usage of public health services was surveyed from October 1, 2006 to October 20, 2006. Following conclusions were reached on the basis of the questionnaire : - For demographic sociological peculiarities, gender, age, occupation, and education level were evenly distributed. Most were under normal marriage(67.38%), health insurance(86.39%), 494(36.0%) individuals with less than monthly income of 1 million won, 494(36.0%) individuals with monthly income between 1 and 2 million won, 219(16.0%) with monthly income between 2 and 3 million won, and 164(12.0%) individuals with more than 3 million won, thus showing relatively low income. - For health status, 1,199(70.28%) individuals are non-smokers, 209(45.63%) individuals smoke $10{\sim}20$ cigarettes a day, 754(44.02%) individuals exercise less than twice a week are the major sector of the population. 1,518(88.10%) individuals have regular checkup more than once and 1,131(65.49%) stated their health condition less than average. - For comparison of existence of illnesses between genders, there was no statistical significance on cancer, stroke, and diabetes. But statistical significance was shown on hypertension(P value 0.025), arthritis(P value 0.000), and cardiac disorders(P value 0.016). Statistical significance was seen in the age comparison, and OR(confidence interval) drastically increased with increase in age. - There was no difference between the primary health clinic(P value 0.000), most visited clinic(P value 0.000), selection criteria(P value 0.000), and satisfaction on efficacy(P value 0.000). There was a tendency preferring hospital than public health center with increase in income. - For correlation between the existence of illnesses among different income levels, except for cancer(P value 0.172), statistical significance was seen in hypertension(P value 0.000), stroke(P value 0.003), diabetes (P value 0.001), arthritis(P value 0.000), and cardiac disorders(P value 0.000). The number of individuals suffering from illnesses and ratio all decreased for all illnesses with increase in income. - After adjusting confounding factors(gender, age, income, marriage, occupation, education) and male (1) as the standard, OR (confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 0.47(0.11${\sim}$2.05), 1.27(0.89${\sim}$1.81), 0.58(0.21${\sim}$1.59), 0.71(0.41${\sim}$1.23), 1.79(1.34${\sim}$2.39, P<0.01), and 1.46(0.72${\sim}$2.96), respectively. Risk of arthritis is significantly high in female and 20's (1) as the standard, OR(confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 1.01(0.96${\sim}$1.07), 1.06(1.04${\sim}$1.07, P<0.01), 1.05(1.01${\sim}$1.10, P<0.01), 1.06(1.03${\sim}$1.08, P<0.01), 1.05(1.03${\sim}$1.06, P<0.01), and 1.06(1.04${\sim}$1.09, P<0.01), respectively. Risk of onset for illnesses significantly increased with yearly aging except for cancer. - For comparison between monthly income after adjusting confounding factors(gender, age, income, marriage, occupation, education), with less than 1 million won (1) as the standard, OR(confidence interval) of cancer for 1 to 2 million won, 2 to 3 million won, and more than 3 million won were 0.23(0.03${\sim}$2.16), 2.53(0.41${\sim}$15.43), and 1.73(0.15${\sim}$19.50), respectively. OR(confidence interval) of hypertension were 1.12(0.76 ${\sim}$1.66), 0.68(0.34${\sim}$1.34), and 2.04(1.08${\sim}$3.86, P<0.01), respectively. OR(confidence interval) of stroke were 0.96(0.30${\sim}$3.08) for 1 to 2 million won, and 0.80(0.08${\sim}$8.46) for 2 to 3 million won. OR(confidence interval) of diabetes were 0.73(0.38${\sim}$1.38), 0.65(0.24${\sim}$1.71), and 0.69(0.24${\sim}$2.01), respectively. The values were 0.76(0.55${\sim}$1.03), 1.14(0.75${\sim}$1.73), and 0.90(0.56${\sim}$1.46), respectively for arthritis. OR(confidence interval) of cardiac disorders were 1.15(0.53${\sim}$2.48), 0.63(0.13${\sim}$3.12), and 1.20(0.28${\sim}$5.14), respectively. Risks of cancer, hypertension, stroke, diabetes, arthritis, and cardiac disorders were dependent of monthly income, and stroke and diabetes decreased with increase in income. Summarizing above data, arthritis was significantly higher in women and increase in age by each year brought significant increase in the chance of onset in hypertension, stroke, diabetes, arthritis, and cardiac disorders except for cancer. Stroke and diabetes decreased with increase in income. Above findings can be applied and reflected in public health policies at the national level, and it can also be applied at the personal level for individual health maintenance and prevention.

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Nutritional Risks Analysis Based on the Food Intake Frequency and Health-related Behaviors of the Older Residents (50 Years and Over) in Andong Area (1) (안동주변 농촌지역 50세 이상 주민의 식품섭취빈도 및 건강행위에 따른 영양위험 분석 (1))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.8
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    • pp.998-1008
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    • 2008
  • This study aimed to assess the nutritional status and the nutritional risks based on the food intake frequency and health-related behaviors of middle-aged and elderly people living in Andong area. Interviews were conducted with 1,384 subjects (532 males, 852 females) aged 50 years and over. Nutrient intakes, food intake frequency, and health-related behaviors including smoking, drinking, and exercise were investigated. The average energy intakes were 1410.5 kcal for males and 1279.2 kcal for females, and the percentages of the subjects consuming below the estimated energy requirement (EER) were 92.5% and 88.4%, respectively. The least consumed nutrients compared to the estimated average requirement (EAR) were riboflavin (92.5% for males, 89.6% for females), folic acid (89.7%, 88.5%), and calcium (78.9%, 85.8%), in order. According to the food intake frequency survey, the intakes of meat, fish and vegetable (except kimchi) were very poor, and this low intakes of meat and fish showed as poor status of protein, niacin, vitamin $B_6$, and zinc intakes. Health-related behaviors data showed that the ratio of cigarette smokers, especially male, was higher, while the ratio of the person exercising regularly was lower than that of the nationwide statistics, respectively. Cigarette smoking and drinking were not significantly related to the poor nutrition intake, while regular exercise positively influenced nutrient intakes in female subjects. These results showed that the nutritional status of the subjects was likely to be severely deficient and the low intakes of meat and fish to be highly related to the increase of nutritional risk. Therefore, in order to prevent the occurrence of the secondary disease related to the food intake and health-related behaviors of the subjects, the proper educational program on balanced dietary intake and the correction of health-related behaviors should be developed and applied to this area.

Comparison of Dietary Patterns, Health, and Blood Parameters of Elderly Women and College Women in the Seoul Area (노화 과정에 따른 노인과 여대생의 식생활, 건강 상태 및 혈액 성상 비교 연구)

  • Shin, Kyung-Ok;Chung, Keun-Hee;Choi, Kyung-Soon
    • Journal of the East Asian Society of Dietary Life
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    • v.19 no.5
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    • pp.703-712
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    • 2009
  • The principal objective of this study was to supply basic material determine basic information regarding effective health promotion regimens for elderly women via a comparative survey of health status by aging age between elderly women (=70 y) and college women. The subject groups of elderly women (=70 y) and college women were selected and surveyed from March to October, 2008, in the Seoul area. The average age of the elderly women assessed in this study was $78.64{\pm}7.30$, the average height was $147.07{\pm}5.72$ cm, and the average weight was $50.47{\pm}7.44$ kg. As compared with college women, a higher percentage of elderly women ate breakfast regularly, but the elderly women also experienced difficulties in chewing due to dentures, and therefore ate their meals with large quantities of liquids, and usually ate their meals within 10 minutes. The majority of elderly women suffered from at least one disease, and the most common symptom reported was hypertension (25%). 52.2% of elderly women and 47.8% of college women reported that they exercised 1~2 times per week. They reported that their favorite exercise was light exercise, such as jogging and athletics (73.1%). As compared with college women, the smoking rate was lower among elderly women, but some of the elderly women were long-time smokers or alcoholics. The differences in red blood cells counts, Hb, hematocrit, and MCV of the between elderly women and college women were significant. In addition, but the MCH and MCHC were higher in elderly women compared with college women and the total cholesterol of elderly woman ($175.62{\pm}38.89$ mg/dL) was significantly lower compared with college woman ($186.13{\pm}28.19$ mg/dL). TG ($127.89{\pm}51.25$ mg/dL) and LDL-cholesterol ($120.51{\pm}32.88$ mg/dL) of elderly woman were significantly higher than TG ($79.71{\pm}40.9$ 6mg/dL) and LDL-cholesterol($103.78{\pm}22.94$ mg/dL) of college woman (p<0.05). The levels of HDL-cholesterol ($58.78{\pm}12.90$ mg/dL) in the college women was significantly higher than the HDLcholesterol levels ($48.17{\pm}13.79$ mg/dL) of the elderly women (p<0.05). Serum vitamin C levels in elderly women were significantly higher than those of college women (p<0.05), whereas no significant difference was detected between the two groups. Consequently, it can be concluded that the appropriate education programs for dietary habits and health promotion are necessary for a healthier life. Additionally, it is necessary for individuals to precisely determine precisely their own health status, and develop appropriate dietary programs for themselves.

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The Histologic Type of Lung Cancer in Idiopathic Pulmonary Fibrosis : the Difference According to the Presence of Fibrosis at Cancer Location (특발성 폐섬유화증에서 발생한 폐암의 조직형의 특성 : 폐암 위치의 섬유화 유무에 따른 조직형의 차이)

  • Kwon, Sung-Youn;Kim, Deog-Kyeom;Lee, Suk-Young;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Im, Jung-Gi;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.441-452
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    • 2000
  • Background : It is well known that the prevalence of lung cancer is higher in idiopathic pulmonary fibrosis (IPF) patients than in the general population. This high prevalence is explained by the concept of 'scar carcinoma'. There have been several reports on the prevalence of histologic typo of lung cancer in IPF with conflicting results. Despite of the high smoker rate in almost all previous reports, none considered the smoking history of patients. Therefore we performed a separate studies on fibrosis associated lung cancer and smoking associated lung cancer. The purpose of this study is to investigate the proportion of lung cancer in IPF that is fibrosis associated and to determine the most common histologic type in fibrosis associated lung cancer in IPF. Method : A retrospective review of medical records and radiologic studies was performed for cases of lung cancer with IPF. We investigated smoking history, sequence of diagnosis of lung cancer and IPF, histologic type of lung cancer and the cancer location, especially whether the location is associated with fibrosis. To evaluate the proportion of fibrous associated lung cancer, the lung cancer in IPF were categorized according to the presence of fibrosis at cancer location. Results : Fifty seven patients were subjects for this analysis. Six (11%) cases were diagnosed as lung cancer during follow-up for IPF, and both diseases were diagnosed simultaneously in the others. Ninety four percent of patients were smokers and the average smoking amount was 47.1$\pm$21.9 pack-year. Among the patients with IPF and lung cancer, 42(80.8%) cases were considered as "fibrosis associated". The remainder was "not fibrosis associated" and probably was due to smoking etc. Although the most frequent histologic type was squamous cell carcinoma as a whole, adenocarcinoma was the prominent histologic type in "fibrosis associated lung cancer." Conclusion : Considering the proportion of "fibrosis not associated lung cancer" in the patients with IPF and lung cancer, significant proportion of lung cancer in IPF may not be fibrosis induced. This may influence the distribution of histologic type of lung cancer in IPF.

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Peak Expiratory Flow in Normal Healthy Korean Subjects Measured by Mini-Wright Peak Flow Meter (Mini-Wright Peak Flow Meter로 측정한 한국 성인의 최고호기유량의 정상치)

  • 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
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    • 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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The Study on the Independent Predictive Factor of Restenosis after Percutaneous Coronary Intervention used Drug-Eluting Stent : Case on MDCT Calcium-Scoring Implementation Patient (약물용출 스텐트를 이용한 관상동맥중재술 후 재협착의 독립적 예측인자에 관한 연구 : MDCT calcium-scoring 시행 환자 대상으로)

  • Kim, In-Soo;Han, Jae-Bok;Jang, Seong-Joo;Jang, Young-Ill
    • Journal of radiological science and technology
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    • v.33 no.1
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    • pp.37-44
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    • 2010
  • We sought to confirm an independent factor about in-stent restenosis (ISR) in the patients who underwent drug-eluting stent (DES) and know a possibility as a predictor of measured coronary artery calcium score by MDCT. A total of 178 patients (159 men, $61.7{\pm}10.0$ years of age) with 190 coronary artery lesions were included in this study out of 1,131 patients who underwent percutaneous coronary intervention (PCI) with DES implantation for significant stenosis on MDCT at Chonnam National University Hospital between May 2006 and May 2009. All lesions were divided into two groups with the presence of ISR : group I (re ISR, N = 57) and group II (no ISR, N = 133). Compared to group II, group I was more likely to be older ($65.8{\pm}9.0$ vs. $60.2{\pm}9.9$ years, p = 0.0001), diabetic (21.8% vs. 52.6%, p = 0.0001), have old myocardial infarction (8.8% vs. 2.3%, p = 0.040), left main stem disease (5.3% vs. 0.8%, p = 0.047), and smaller stent size ($3.1{\pm}0.3\;mm$ vs. $3.3{\pm}0.4\;mm$, p = 0.004). Group II was more likely to be smokers (19.3% vs. 42.1%, p = 0.003), have dyslipidemia (8.8% vs. 23.3%, p = 0.019). Left ventricular ejection fraction, lesion complexity, and stent length were not different between the two groups. Total CAC score was $389.3{\pm}458.3$ in group I and $371.2{\pm}500.8$ in group II (p = 0.185). No statistical difference was observed between the groups in CAC score in the culprit vessel, left main stem, left anterior descending artery, left circumflex artery, and right coronary artery. On multivariate logistic regression analysis, left main stem disease (OR = 168.0, 95% CI = 7.83-3,604.3, p = 0.001), male sex (OR = 36.5, 95% CI = 5.89-2,226.9, p = 0.0001), and the presence of diabetes (OR = 2.62, 95% CI = 1.071-6.450, p = 0.035) were independent predictors of ISR after DES implantation. In patients who underwent DES implantation for significant coronary stenosis on MDCT, ISR was associated with left main stem disease, male sex, and the presence of diabetes. However, CAC score by MDCT was not a predictor of ISR in this study population.

A Study on the Relationship between Health Food and Health-Related Factors by Residence and Sex in Tong-Yeong Area (거주지역 및 성에 따른 통영지역주민의 건강식품 이용실태 및 건강관련 제요인과의 관련성)

  • Lee, Bog-Ri;Jeong, Bo-Young;Kim, In-Soo;Moon, Soo-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.6
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    • pp.840-849
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    • 2005
  • In order to investigate the relationship between intake conditions of health food and health-related factors by residence and sex in Tong-Young area, a survey was carried out from 1,303 adults. Health foods were classified 3 groups including vitamin and mineral supplements, toner foods and manufactured health food supplements. Health-related factors were stress, fatigue, smoking and drinking. The $29.5\%$ of the subjects had taken some health food for health. Especially the male took more toner foods habitually than the female did. In take of vitamin and mineral supplements by residence, there was a significant difference $(p\leq0.01)$ as follows. The subjects in island $(20.0\%)$ who took vitamin/mineral supplements were about two times as compared with the subjects in Dong $(10.8\%)$, or Eub-Myeon $(10.0\%)$. The subjects taking supplementary food replied over fair $(82.8\%)$, the subjects taking toner food replied over fair (90.3$\%$) scored higher than who replied bad or very bad in self-perceived health status. Therefore, the better the subjects felt self-perceived health status, the more they took health foods for health themselves. In self-perceived stress status, the subjects who replied a little $(50.0\%,\;45.3\%)$ or little $(19.9\%,\;26.4\%)$, took vitamin and mineral supplements or manufactured health foods a lot. In toner food there was a significant correlation $(p\leq0.05)$ as follows. The less the subjects felt stress, the more they took dietry supplement. No smoker $(12.9\%)$intake rate of vitamin and mineral supplements was higher than smoker $(8.8\%)$. Smokers $(6.5\%)$ intake rate of toner food was higher than no smoker $(4.0\%)$. It was not significant the relationship between intake condition of health food and drinking. The main motivation for taking health food were by self-decision and invitation of friends or neighbors.