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Chung Mo Nam 30 Articles
Rates of Change to a Positive Result in Subsequent Screening Mammography in Korean Women: A Retrospective Observational Study
Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim, Yoon-Nam Kim, Chung Mo Nam
J Prev Med Public Health. 2015;48(1):48-52.   Published online December 26, 2014
DOI: https://doi.org/10.3961/jpmph.14.042
  • 10,194 View
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AbstractAbstract PDF
Objectives
This retrospective cohort study aimed at calculating some parameters of changes in the findings of the subsequent screening mammography (SSM) in female Korean volunteers.
Methods
The study included screenees aged 30 to 79 years who underwent SSM voluntarily after testing negative in the baseline screenings performed between January 2007 and December 2011. A change to a positive result was defined as category 4 or 5 by using the American College of Radiology Breast Imaging Reporting and Data System. The proportion of results that had changed to positive (CP, %) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of study participants. The rate of results that had changed to positive (CR, cases per 100 000 screenee-months) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of months of the follow-up period.
Results
The overall CP and CR in all age groups (n=77 908) were 2.26% and 93.94 cases per 100 000 screenee-months, respectively. The median CP interval in the subjects who had positive SSM results was 30 to 36 months, while that in the age group of 30 to 39 years was shorter.
Conclusions
Different screening intervals should be considered among women aged between 30 and 59 years. In addition, a strategy for a screening program should be developed for the age group of 30 to 39 years, in particular.
Summary
Socioeconomic Costs of Stroke in Korea: Estimated from the Korea National Health Insurance Claims Database.
Seung ji Lim, Han joong Kim, Chung mo Nam, Hoo sun Chang, Young Hwa Jang, Sera Kim, Hye Young Kang
J Prev Med Public Health. 2009;42(4):251-260.
DOI: https://doi.org/10.3961/jpmph.2009.42.4.251
  • 7,602 View
  • 148 Download
  • 42 Crossref
AbstractAbstract PDF
OBJECTIVES
To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. METHODS: We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients' and caregivers' productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. RESULTS: A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. CONCLUSIONS: Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.
Summary

Citations

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    Jeong Seon Yoo, Eun Yeong Choe, Yoo Mee Kim, Se Hwa Kim, Young Jun Won
    The Korean Journal of Internal Medicine.2020; 35(4): 936.     CrossRef
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    Jeong Il Lee, Kang Hyun Lee, Oh Hyun Kim, Roberto Cirocchi
    Emergency Medicine International.2020; 2020: 1.     CrossRef
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    Sang-Mi Kim, Young Kim, Seong-A Lee
    Physical Therapy Rehabilitation Science.2019; 8(2): 67.     CrossRef
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    Yongsun Ahn, Donghyun Jee
    Journal of the Korean Ophthalmological Society.2019; 60(8): 765.     CrossRef
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    Ickpyo Hong, Young Joo Kim, Mandi L. Sonnenfeld, Emily Grattan, Timothy A. Reistetter
    Annals of Rehabilitation Medicine.2018; 42(2): 336.     CrossRef
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    International Journal of Health Policy and Management.2018; 7(10): 904.     CrossRef
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    Journal of Korean Neurosurgical Society.2017; 60(2): 195.     CrossRef
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    Sun-Mi Kim, Da-Yang Kim, Kwang-Soo Lee
    The Korean Journal of Health Service Management.2017; 11(1): 91.     CrossRef
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    Changwoo Shon, Hyung-Yun Choi, Jae-Jun Shim, So-Youn Park, Kyung Suk Lee, Seok-Jun Yoon, In-Hwan Oh
    Japanese Journal of Infectious Diseases.2016; 69(1): 18.     CrossRef
  • Validation of Stroke and Thrombolytic Therapy in Korean National Health Insurance Claim Data
    Tai Hwan Park, Jay Chol Choi
    Journal of Clinical Neurology.2016; 12(1): 42.     CrossRef
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    Jae Ho Chung, Jung Bin Kim, Ji Hyun Kim
    Journal of Neurology.2016; 263(10): 2032.     CrossRef
  • The Epidemiology and Economic Burden ofClostridium difficileInfection in Korea
    Hyung-Yun Choi, So-Youn Park, Young-Ae Kim, Tai-Young Yoon, Joong-Myung Choi, Bong-Keun Choe, So-Hee Ahn, Seok-Jun Yoon, Ye-Rin Lee, In-Hwan Oh
    BioMed Research International.2015; 2015: 1.     CrossRef
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    International Journal of Cardiology.2015; 191: 244.     CrossRef
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    Neuro-Oncology Practice.2015; 2(2): 93.     CrossRef
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    International Journal of Stroke.2015; 10(SA100): 75.     CrossRef
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    Dong Wook Kim, Seo‐Young Lee, Soo‐Eun Chung, Hae‐Kwan Cheong, Ki‐Young Jung
    Epilepsia.2014; 55(1): 67.     CrossRef
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    Respiratory Medicine.2014; 108(1): 153.     CrossRef
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    COPD: Journal of Chronic Obstructive Pulmonary Disease.2014; 11(2): 163.     CrossRef
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    International Journal of Stroke.2013; 8(3): 186.     CrossRef
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    Journal of Stroke.2013; 15(1): 2.     CrossRef
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    Expert Review of Pharmacoeconomics & Outcomes Research.2013; 13(4): 549.     CrossRef
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The Association between Obesity Indices in Adolescence and Carotid Intima-media Thickness in Young Adults: Kangwha Study.
Yoo Jung Lee, Chung Mo Nam, Hyeon Chang Kim, Nam Wook Hur, Il Suh
J Prev Med Public Health. 2008;41(2):107-114.
DOI: https://doi.org/10.3961/jpmph.2008.41.2.107
  • 5,332 View
  • 42 Download
  • 9 Crossref
AbstractAbstract PDF
OBJECTIVES
The aim of this study is to investigate the association between obesity indices (body mass index, weight, waist-hip ratio and waist circumference) in adolescents and the carotid intima-media thickness (C-IMT) in early adulthood. We also wanted to identify the best predictor for C-IMT among these obesity indices. METHODS: This study used community-based prospective cohort study, known as the Kangwha Study, and the data we used were from subjects who were 16-years old in 1996 (defined as "adolescencec") and 25 years-old in 2005 (defined as "early adulthoodc"). The 256 subjects (113 men and 143 women) who were used for analysis participated in both follow-ups, and they underwent B-mode ultrasonography of the carotid arteries at the early adulthood follow-up. Obesity indices were defined as the body mass index, weight, waist-hip ratio and waist circumference. The C-IMT was defined as the mean of the maximal IMT of each common carotid artery. The C-IMT and obesity indices associations were evaluated via multivariable regression, logistic regression and the receiver-operator characteristic curve analyses. RESULTS: In men, all the obesity indices in adolescence were showed to have statistically significant positive association with C-IMT in early adulthood. However, no such relationship was showed in women. On multiple regression and logistic regression analysis, the waist-hip ratio showed the biggest relationship with the C-IMT among the 4 obesity indices. However, there were no statistical significant differences and no best predictor was found. For the women, the obesity incidences and C-IMT showed no relationships. CONCLUSIONS: This study suggested that obesity in adolescence was related to an increase C-IMT in healthy young Korean men.
Summary

Citations

Citations to this article as recorded by  
  • Application of Standardized Regression Coefficient in Meta-Analysis
    Pentti Nieminen
    BioMedInformatics.2022; 2(3): 434.     CrossRef
  • Comparison analysis of childhood body mass index cut-offs in predicting adulthood carotid intima media thickness: Tehran lipid and glucose study
    Farhad Hosseinpanah, Amirhosein Seyedhoseinpour, Maryam Barzin, Maryam Mahdavi, Erfan Tasdighi, Pooneh Dehghan, Amin Momeni Moghaddam, Fereidoun Azizi, Majid Valizadeh
    BMC Pediatrics.2021;[Epub]     CrossRef
  • Asian Cohort Studies on Cardiovascular Risk Factors in Childhood
    Sun Jae Jung, Hyeon Chang Kim, Il Suh
    Cardiovascular Prevention and Pharmacotherapy.2019; 1(1): 3.     CrossRef
  • Carotid intima media thickness in obese children: is there an association with hyperlipidemia?
    Zehra Esra Önal, Levent Soydan, Hatice Eren Öztürk, Çiğdem Sağ, Tamay Gürbüz, Çağatay Nuhoğlu, Mehmet Masum Şimşek
    Journal of Pediatric Endocrinology and Metabolism.2016;[Epub]     CrossRef
  • Analysis for the Patterns of Medical Care Utilization during 19 Years (1990-2008) and Its Related Factors in Hypertensive Patients Using National Patient Survey in Korea
    Nam Wook Hur, Hyeon Chang Kim
    Journal of the Korean Society of Hypertension.2014; 20(1): 8.     CrossRef
  • Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome
    Hye Ah Lee, Hyesook Park
    Journal of Preventive Medicine and Public Health.2013; 46(4): 173.     CrossRef
  • Longitudinal Standards for Height and Height Velocity in Korean Children and Adolescents: the Kangwha Cohort Study
    Hyun Wook Chae, Il Suh, Ah Reum Kwon, Ye Jin Kim, Yong Hyuk Kim, Dae Ryong Kang, Ha Yan Kim, Sun Min Oh, Hyeon Chang Kim, Duk Hee Kim, Ho-Seong Kim
    Journal of Korean Medical Science.2013; 28(10): 1512.     CrossRef
  • Clinical characteristics of obese boys and girls in a high school: focused on abdominal fat indices, fatty liver and carotid intima-media thickness
    Jung Eun Oh, Jiyoung Jung, Hae Soon Kim, Young Mi Hong, Jung Hyun Yoo, Young Whan Song, Jo Won Jung, Nam Su Kim, Chung Il Noh
    Korean Journal of Pediatrics.2011; 54(7): 292.     CrossRef
  • Association between Blood Pressure and Carotid Intima-Media Thickness
    Sun Min Lim, Hyeon Chang Kim, Hoon Sang Lee, Joo Young Lee, Mina Suh, Song Vogue Ahn
    The Journal of Pediatrics.2009; 154(5): 667.     CrossRef
Dipstick Urine Protein, as a Predictor of Cardiovascular Mortality in Korean Men: Korea Medical Insurance Corporation Study.
Kyoungsoo Ha, Hyeon Chang Kim, Dae Ryong Kang, Chung Mo Nam, Song Vogue Ahn, Il Suh
J Prev Med Public Health. 2006;39(5):427-432.
  • 2,416 View
  • 51 Download
AbstractAbstract PDF
OBJECTIVES
This study was to investigate if the dipstick proteinuria can predict cardiovascular mortality in a population of Korean men. METHODS: We measured urine protein and other cardiovascular risk factors in 100059 Korean men, aged between 35-59 years in 1990 and 1992. Levels of proteinuria measured by dipstick method were trace or less, 1+, 2+, and 3+ or greater. The primary outcomes were deaths from all causes, cardiovascular disease, cancer, and others in a 12 year follow-up from 1993 to 2004. RESULTS: The multivariate-adjusted relative risks (95% CI) for cardiovascular death according to the level of proteinuria (1+, 2+, 3+ and more) in 1990 examination were 2.18 (1.36-3.48), 2.55 (1.37-4.78), and 4.57 (2.16-9.66) respectively. The corresponding relative risks according to the level of proteinuria in 1992 examination were 2.49 (1.71-3.64), 2.64 (1.53-4.58), and 2.78 (1.15-6.73). The relative risks for cardiovascular death of men with proteinuria (1+ or greater) once and twice among the examinations were 2.18 (1.63-2.92) and 3.75 (2.27-6.18), compared with men without proteinuria in 1990 and 1992 examinations. CONCLUSIONS: Our results showed that dipstick proteinuria is associated with cardiovascular mortality in Korean men. Dipstick proteinuria could be a predictor for cardiovascular mortality.
Summary
A Study on Scheduling Periodic Examinations for the Early Detection of Breast Cancer in Korea.
Seong Hwa Jeong, Dae Ryong Kang, Nam Wook Hur, Jinheum Kim, Soon Young Lee, Sang Hyuk Jung, Chung Mo Nam
J Prev Med Public Health. 2006;39(4):346-352.
  • 2,434 View
  • 37 Download
AbstractAbstract PDF
OBJECTIVES
The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. METHODS: The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. RESULTS: For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. CONCLUSIONS: The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.
Summary
Kangwha Study Association Analysis of the Essential Hypertension Susceptibility Genes in Adolescents: Kangwha Study.
Il Suh, Chung Mo Nam, Sung Joo Kim, Dong Jik Shin, Nam Wook Hur, Dae Ryong Kang
J Prev Med Public Health. 2006;39(2):177-183.
  • 2,407 View
  • 62 Download
AbstractAbstract PDF
OBJECTIVES
In this study we examined the association between the genetic markers ACE (A-240T, C-93T, I/D, A2350G), AGT (M235T), AT1R (A1166C), CYP11B2 (T-344C, V386A), REN (G2646A), ADRB2 (G46A, C79G, T-47C, T164I), GNB3 (C825T) and ADD1 (G460W) and the presence of essential hypertension in adolescents. METHODS: The Kangwha Study is an 18-year prospective study that is aimed at elucidating the determinants of the blood pressure level from childhood to early adulthood. For this study, we constructed a case-control dataset of size of 277 and 40 family trios data from the Kangwha Study. For this purpose, we perform a single locus-based case-control association study and a single locus-based TDT (transmission/disequilibrium test) study. RESULTS: In the case-control study, the single locus-based association study indicated that the ADD1 (G460W) (p=0.0403), AGT (M235T) (p=0.0002), and REN (G2646A) (p=0.0101) markers were significantly associated with the risk of hypertension. These results were not confirmed on the TDT study. This study showed that genetic polymorphisms of the ADD1, AGT and REN genes might be related to the hypertension in Korean adolescents. CONCLUSIONS: This study provided useful information on genetics markers related to blood pressure. Further study will be needed to confirm the effect of the alpha adducin gene, the angiotensinogen gene and the renin gene on essential hypertension.
Summary
Statistical Algorithm in Genetic Linkage Based on Haplotypes.
Jinheum Kim, Dae Ryong Kang, Yun Kyung Lee, Sun Mi Shin, Il Suh, Chung Mo Nam
J Prev Med Public Health. 2004;37(4):366-372.   Published online November 30, 2004
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to propose a new transmission/disequilibrium test (TDT) to test the linkage between genetic markers and diseasesusceptibility genes based on haplotypes. Simulation studies were performed to compare the proposed method with that of Zhao et al. in terms of type I error probability and powers. METHODS: We estimated the haplotype frequencies using the expectation-maximization (EM) algorithm with parents' genotypes taken from a trio dataset, and then constructed a two-way contingency table containing estimated frequencies to all possible pairs of parents' haplotypes. We proposed a score test based on differences between column marginals and their corresponding row marginals. The test also involved a covariance structure of marginal differences and their variances. In simulation, we considered a coalescent model with three genetic markers of biallele to investigate the performance of the proposed test under six different configurations. RESULTS: The haplotype-based TDT statistics, our test and Zhao et al.'s test satisfied a type I error probability, but the TDT test based on single locus showed a conservative trend. As expected, the tests based on haplotypes also had better powers than those based on single locus. Our test and that of Zhao et al. were comparable in powers. CONCLUSION: We proposed a TDT statistic based on haplotypes and showed through simulations that our test was more powerful than the single locus-based test. We will extend our method to multiplex data with affected and/or unaffected sibling (s) or simplex data having only one parent's genotype.
Summary
Factors Associated with Hypertension Control and Antihypertensive Medication among Hypertensive Patients in a Community.
Dong Han Lee, Youn Hee Choi, Kang Hee Lee, Dae Ryong Kang, Sun Ha Jee, Chung Mo Nam, Il Suh
Korean J Prev Med. 2003;36(3):289-297.
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AbstractAbstract PDF
OBJECTIVES
The main objectives of this study are to identify the factors associated with hypertension control and to determine the influencing factors associated with antihypertensive therapy. METHODS: The study was conducted on 107 subjects who participated in the 1999 and 2002 Gwacheon Study and who had had uncontrolled hypertension (systolic > or=140 or diastolic > or= 90mmHg) in 1999. We compared the characteristics of the controlled and uncontrolled hypertensive group and investigated the characteristics of those taking antihypertensive medication. Univariate associations between hypertension control and its characteristics and the association between antihypertension treatment and its characteristics were tested with x2-test. We also performed logistic regression analysis. RESULTS: The participants who had their blood pressure checked within 6 months before their first measurement and those who had taken the antihypertensive medication showed significantly better hypertension control during the follow-up. The multivariate analysis showed that baseline antihypertensive therapy was the most important determinant factor of hypertension control during the follow-up. Socioeconomic level and life style did not affect hypertension control when controlled by the treatment variable in this study. The factors associated with antihypertensive therapy at follow-up were previous antihypertensive therapy, old age, and high educational level. CONCLUSIONS: Those who received antihypertensive therapy and those who had their blood pressure re-checked within 6 months both showed well controlled hypertension. The subjects with high educational level complied well with the antihypertensive regimen, but those in their forties did not.
Summary
Awareness, Treatment, Control, and Related Factors of Hypertension in Gwacheon.
Youn Hee Choi, Chung Mo Nam, Mi Hyun Joo, Ki Tae Moon, Jee Seon Shim, Hyeon Chang Kim, Il Suh
Korean J Prev Med. 2003;36(3):263-270.
  • 2,362 View
  • 36 Download
AbstractAbstract PDF
OBJECTIVES
To identify the factors related to awareness, treatment, and control of hypertension in a Gwacheon population. METHODS: This study surveyed 1, 176 Gwacheon residents older than 40 years, and measured blood pressure using a standardized guideline in 1999. The study subjects were 473 adults (175 males, 298 females) with hypertension defined as a systolic blood pressure > or= 140 mmHg, diastolic blood pressure > or= 90 mmHg or reported treatment with antihypertensive medications. Information on awareness, treatment, and control of hypertension, and sociodemographic and health-related factors was collected through person-to-person interviews with a structured questionnaire. RESULTS: Overall, 252 (53.3%) of hypertensive subjects were aware of their condition, of whom as many as 193 (76.6%) were being treated, and 81 (42.0%) had their blood pressure controlled at the recommended level (< 140/90 mmHg). However, of the 473 subjects found to have hypertension, only 40.8% were being treated, and 17.1% were under control. There were no significant differences in the proportions of awareness, treatment, and control of hypertension. In multiple logistic regression models, awareness of hypertension was positively associated with age and family history of hypertension in females. Control of hypertension was also positively associated with having a partner and marital status in females. CONCLUSION: These findings demonstrate that much greater efforts on improving awareness, treatment, and control of hypertension are needed, even in urban community settings, considering related factors such as age, family history, and marital status. However, these factors should be further investigated for their causal relationship.
Summary
Comparing Difference of Volume of Psychiatric Treatments between the Patient with Health Insurance and Those with Medical Assistance: For Inpatients of Korean Psychiatric Hospitals.
Dae Hee Lee, Eun Cheol Park, Chung Mo Nam, Sang Gyu Lee, Dong Han Lee, Seung Hum Yu
Korean J Prev Med. 2003;36(1):33-38.
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OBJECTIVES
To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance (the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. METHODS: 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. RESULTS: A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder) were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. CONCLUSIONS: More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.
Summary
Cigarette Smoking, Alcohol and Cancer Mortality in Men: The Kangwha Cohort Study.
Sang Gyu Lee, Chung Mo Nam, Sang Wook Yi, Hee Chul Ohrr
Korean J Prev Med. 2002;35(2):123-128.
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AbstractAbstract PDF
OBJECTIVE
To examine the relationship between cigarette smoking, alcohol and cancer mortality in men in the Kangwha cohort after 12 years and 10 months of follow up. METHODS: The subjects consisted of 2,681 men in the Kangwha cohort aged over 55 in 1985. Number of deaths and the time to death from all cancers and other cause were measured and the data for the smoking and drinking habits were obtained from the baseline survey data in 1985. All subjects were categorized into four groups according to their smoking habits: non-smokers, ex-smokers, moderate-smokers (1-19 cigarettes per day), heavy-smokers (> or =20 cigarettes per day). In addition, they were also categorized according to their drinking habits: non-drinkers, light-drinkers (< or =1 drink per week), moderate-drinkers (<3 drinks per day), heavy-drinkers (> or =3 drinks per day). The cancer specific death rates were calculated according to their smoking and drinking status. The adjusted risk ratio for all cancer deaths according to their smoking and drinking status were estimated using the Cox's proportional hazard regression model. RESULTS: Using nonsmokers as the reference category, the adjusted risk ratio for all cancer deaths were 1.573(95% CI=1.003-2.468) for heavy-smokers. For lung cancer deaths, the adjusted risk ratios were 3.540(95% CI=1.251-10.018) for moderate-smoker and 4.114(95% CI=1.275-13.271) for heavy-smokers. Compared to non-drinkers, the adjusted risk ratio for stomach cancer was 2.204(95% CI=1.114-4.361) for light-drinkers. CONCLUSION: Smoking is the most significant risk factor for cancer deaths particularly lung cancer.
Summary
Pesticides and Cancer Incidence: The Kangwha Cohort Study.
Jae Woong Sull, Sang Wook Yi, Tae Yong Sohn, Sun Ha Jee, Chung Mo Nam, Heechul Ohrr
Korean J Prev Med. 2002;35(1):24-32.
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OBJECTIVE
Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. METHODS: We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks (RR). RESULTS: At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 146 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95% CI=1.0-1.9), p for trend=0.041, for digestive organ cancer incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0 (95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.8-27.9)). CONCLUSIONS: This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.
Summary
A Meta-analysis of the Association between Blood Lead and Blood Pressure.
Sang Baek Koh, Chun Bae Kim, Chung Mo Nam, Hong Ryul Choi, Bong Suk Cha, Jong Ku Park, Ho Sung Jee
Korean J Prev Med. 2001;34(3):262-268.
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OBJECTIVES
To integrate the results of studies which assess an association between blood lead and blood pressure. METHODS: We surveyed the existing literature using a MEDLINE search with blood lead and blood pressure as key words, including reports published from January 1980 to December 2000. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers exposed to lead, and 2) both blood pressure and blood lead must have been measured and presented with sufficient details so as to estimate or calculate the size of the association as a continuous variable. Among the 129 articles retrieved, 13 studies were selected for quantitative meta-analysis. Before the integration of each regression coefficient for the association between blood pressure and blood lead, a homogeneity test was conducted. RESULTS: As the homogeneity of studies was rejected in a fixed effect model, we used the results in a random effect model. Our quantitative meta-analysis yielded weighted regression coefficients of blood lead associated with systolic blood pressure and diastolic blood pressure results of 0.0047 (95% confidence interval [CI]: -0.0061, 0.0155) and 0.0004 (95% CI: -0.0031, 0.0039), respectively. CONCLUSIONS: The published evidence suggested that there may be a weak positive association between blood lead and blood pressure, but the association is not significant.
Summary
Analysis of Socioeconomic Costs of Smoking in Korea.
Han Joong Kim, Tae Kyu Park, Sun Ha Jee, Hye Young Kang, Chung Mo Nam
Korean J Prev Med. 2001;34(3):183-190.
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OBJECTIVE
To estimate the annual economic costs attributable to cigarette smoking in Korea. METHODS: The costs were classified as being direct medical and non-medical costs, indirect costs and others. We focused on those costs related that are incurred in the treatment of selected diseases (cardiovascular diseases, respiratory diseases, and cancers), which have been proven to be caused by smoking. In addition to the basic costs of treatment, the additional amount of costs occurred due to smoking was obtained by computing the population attributable risk (PAR%) caused by smoking. To compute the PAR%, relative risks of smoking to the number of outpatient visits, hospitalizations, and the death were estimated using the Cox proportional hazard model, respectively. Our major data source was the 'Korea Medical Insurance Corporation (KMIC) cohort study,' which was composed of a total of 115,682 male and 67,932 female beneficiaries who had complete records of their smoking histories in the year of 1992. RESULTS: The annual costs that could be attributable to smoking were estimated to be in the range of 2,847,500 million Won to 3,959,100 million Won. The maximum estimate of 3,959,100 million Won includes 233,100 million Won for medical costs, 5,100 million Won for transportation costs, 27,600 million Won for care giver's economic costs, 69,100 million Won in productivity loss, 3,435,000 million Won lost because of premature death, 172,100 million Won in costs resulting from passive smoke inhalation and 17,100 million Won for costs that resulted from fires that were caused by careless smoking. CONCLUSION: Our study confirms that the magnitude of the economic burden of smoking to Korean society is substantial. Therefore, this study provides strong evidence that there is a strong need for a national policy of tobacco control in Korea.
Summary
Timing of Menarche and Physical Growth during Childhood and Adolescence: The Kangwha Study.
Chang Soo Kim, Chung Mo Nam, Duck Hi Kim, Hyun Chang Kim, Kang Hee Lee, Sun Ha Jee, Il Suh
Korean J Prev Med. 2000;33(4):521-529.
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OBJECTIVES
To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.
Summary
A Meta-analysis on the Association between Chronic Noise Exposure and Blood Pressure.
Chun Bae Kim, Sang Baek Koh, Jai Young Kim, Bong Suk Cha, Hong Ryul Choi, Jong Tae Lee, Chung Mo Nam, Sang Yun Lee, Seung jun Wang, Keeho Park, Dae Youl Kim
Korean J Prev Med. 2000;33(3):343-348.
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OBJECTIVES
This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. METHODS: Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. RESULTS: All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studies were accomplished in a resting state, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. CONCLUSIONS: Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.
Summary
Twelve-year Incidence of Hypertension and Its Risk Factors in a Lean Population: the Kangwha Study.
Hyeon Chang Kim, Il Suh, Kang Hee Lee, Sun Ha Jee, Chang Soo Kim, Chung Mo Nam
Korean J Prev Med. 1999;32(4):435-442.
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OBJECTIVES
The purpose of this study was to examine the twelve-year incidence of hypertension, and to find risk factors for the incidence in adult population in Kangwha County, Korea. METHODS: In 1986, 413 males(mean age 37 years) and 434 females(mean age 33 years) were examined in the Kangwha Study. Among 764 non-hypertensive participants, 164 males and 214 females were reexamined in 1998. Blood pressure(BP) was measured with standard mercury sphygmomanometers. Multiple logistic regression analysis was used to estimate the relative risk of risk factors on the incidence of hypertension. RESULTS: During the 12-year period, 68 of 164 males and 53 of 214 females developed hypertension. In a multiple logistic model adjusted for age and pulse rate, baseline BP, baseline body mass index(BMI) and BMI change during the follow-up period were significantly related to the incidence of hypertension. Adjusted relative risk(RR)s of baseline high-normal BP were 3.90(95% CI: 1.81-7.84) in males, and 12.72(95% CI: 3.70-30.73) in females. Compared with lower baseline BMI group, adjusted RRs of middle baseline BMI group were 2.66(95% CI: 1.19-5.70) in males, and 2.33(95% CI: 0.95-5.55) in females. Adjusted RRs of upper baseline BMI group were 3.52(95% CI: 1.53-7.67)in males and 3.63(95% CI: 1.50-8.43) in females. Increase of BMI was positively related to the incidence in males(adjusted RR=2.71, 95% CI: 1.00-6.71) and females(adjusted RR=3.05, 95% CI: 1.29-6.88). CONCLUSIONS: The twelve-year incidence of hypertension was 41.5% in males, and 25.8% in females. Baseline BP, baseline BMI, and BMI change were strongly related to the incidence of hypertension.
Summary
The effect of sodium and potassium intake on blood pressure change in Korean adolescents.
Il Suh, Chung Mo Nam, Kang Hee Lee, Sun Ha Jee, Suk Il Kim, Gyu Sang Kim, Chun Bae Kim
Korean J Prev Med. 1998;31(3):384-394.
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In order to investigate the effect of the urinary excretion of sodium and potassium on the change on blood pressure over 3 years, 668 adolescents aged 13 years living in Kangwha area were investigated in a longitudinal follow-up study. Two measurements were taken on each blood pressure (diastolic, systolic) and the average of the two readings was used in the analysis. Sodium and potassium intake were estimated by the determination of those electrolytes in 24hr urine. The mixed model regression analysis was used to identify the effect of urinary sodium and potassium on the change of blood pressure after controlling for BMI of each age. On simple bivariate analysis no relationship was found between urinary sodium excretion and systolic or diastolic blood pressure among both male and female, however, a significant positive association between urinary potassium excretion and systolic blood pressure among male. The results of mixed regression analysis showed that the body mass index (BMI) were more influential that urinary electrolytes among this study subjects. It suggested that risk factors observed from the adults, may not be identical with that of the growing aged population. After control of the BMI and age, significant association between sodium and diastolic BP among male, and association between potassium and systolic BP among female, were found. In summary, the results indicate that growth has been more influential than dietary factor on blood pressure for growing aged population.
Summary
Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents.
Il Suh, Chung Mo Nam, Sun Ha Jee, Suk Il Kim, Young Ok Kim, Sung Soon Kim, Won Heum Shim, Chun Bae Kim, Kang Hee Lee, Jong Won Ha, Hyung Gon Kang, Kyung Won Oh
Korean J Prev Med. 1997;30(2):308-326.
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Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. a A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic diastolic BP at age 12 and 16 years old were 108.7 mmHg & 118.1 mmHg(systolic), and 69.5 mmHg & 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg & 113.5 mmHg(systolic) and 75.2 mmHg & 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index etc) increased consitantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend for females. Total fat intake increased at age 16 years compared with that at age 14 years. Composition of carbohydrate, protein and fat among total energy intake was 65:15:20 at age 14 and 16 years. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness, showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.
Summary
Four-year change and tracking of serum lipids in Korean adolescents.
Kang Hee Lee, Il Suh, Sun Ha Jee, Chung Mo Nam, Sung Soon Kim, Won Heum Shim, Jong Won Ha, Suk Il Kim, Hyung Gon Kang
Korean J Prev Med. 1997;30(1):45-60.
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AbstractAbstract PDF
It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes and girls. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probability of remaining at the same group was more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in he future to investigate the long-term change of lipids from adolescents to adults.
Summary
Structural Modeling of Health Concern, Health Practice and Health Status of Koreans.
Soon Young Lee, Myong Sei Sohn, Chung Mo Nam
Korean J Prev Med. 1995;28(1):187-206.
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The purpose of this study was to determine the relationships among the health concern, health practice and health status of Koreans. This study utilized the data from Korean individuals(1,304 male and 1,495 females), whose ages were between 20 and 59. The data were analyzed using SAS version 6.04 and LISREL version 7.13. The analytic methods for the study were chi-square analysis and covariance structural analysis. The results of the study were as follows. (1) There were significant positive relationships between health concern level and health practice index, and between health practice index and self-perceived health status. (2)There were negative relationships between practice index and chronic illness, and between health practice index and acute illness only in female. (3) Based on the findings, the structural model of the health concern, health practice, health status and socioeconomic variables was established and then the covariance structural analysis was used. The higher educational level and economic status were, the higher the health concern was. And urban residents were much more concerned with their health than rural residents. The more persons were concerned with health, the more they did health practices. And the more the health practice was, the higher the health status was. The younger the persons were and the higher the health status of one's family was, the higher the health status was. In female, the higher the economic status was, the higher the health status was.
Summary
Impacts of the Implementation of the DRG Based Prospective Payment System on the Medicare Expenditures.
Han Joong Kim, Chung Mo Nam
Korean J Prev Med. 1994;27(1):107-116.
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AbstractAbstract PDF
The united states adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses: (l) The PPS decelerated the increase in the hospital expenditure (part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the part A expenditure were greater than losses in the part B expenditure. The dependent variables are per capita hospital expenditure, per capita part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows: (l) The annual increase in the per capita part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significant (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita part B expenditure was accelerated by $l.73 (t=l.91) after the implementation of the PPS. (3) The increase in the total Medicine expenditure per capita was reduced by $4.26(t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.
Summary
The blood pressure level and sexual maturity in the children at puberty.
Kyoo Sang Kim, Soon Young Lee, Ill Suh, Chung Mo Nam, Sun Hwa Jee
Korean J Prev Med. 1993;26(3):347-358.
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AbstractAbstract PDF
The purpose of this study is to analyze the relationship between the blood pressure level and their sexual maturity and physical growth in the children at puberty. For this purpose, we estimated the blood pressure, physical growth and sexual maturity of the boys of 335 and girls of 373 who are in the middle schools which are located in Kang-wha County, KyungKi-Do. Both systolic and diastolic pressure were measured twice. Such physical growth as height, body weight, skin fold thickness, waist circumference, hip circumference and arm circumference were measured. The sexual maturity was estimated according to the classification of Tanner's 5-phase-sexual-maturity; in boys, their pubic hair development phase; in girls, their pubic hair and breast development phase and the menstrual experience. In the phase of the pubic hair development, the boy's sexual maturity was distributed into this; the 1 st 56.4%, the 2nd 29.3%, the 3rd 9.9%, the 4th 4.1% and the 5th 0.3%. While the girls sexual maturity was distributed into this : the 1 st 20.5%, the 2nd 34.9%, the 3rd 30.6% the 4th 12.6% and the 5th 1.3% in the phase of the pubic hair development, and the 1 st 0.8%, the 2nd 13.7%, the 3rd 36.2%, the 4th 18.8% and the 5th 30.5% in the phase of the breast development. This indicated that the girls sexual maturity was higher than those of the boys. The girls menstrual experience rate accounted to the 58.2%. In order to see the relationship between the children's sexual maturity and blood pressure level, we regress blood pressure level on physical growth(i.e., height, BMI) and sexual maturity. Sexual maturity in treats as dummy variables. As the result of this analysis, the boys' sexual maturity has nothing to do with the blood pressure either systolic or diastolic. But the girl's systolic pressure was statistically significant; the 9% of the physical growth, the 5% of the pubic hair development and the 4% of the breast development in sexual maturity was explained. In the girls' diastolic pressure, only their pubic hair development was statistically significant; the 7% of the physical growth and the 7% of the pubic hair development in the diastolic was explained and the 5% of the physical growth in the diastolic Korotokoff phase was explained, especially, the girls experienced menstruation, their systolic and diastolic pressure were significantly high(P<0.01). Conclusively, in the first grade children attending middle schools who are in the early process of the sexual development, the sexual maturity was not related to blood pressure level, on the other hand, the blood pressure level of the girls who are more sexual development than those of the boys' have something to do with sexual maturity and physical growth.
Summary
The Change In Blood Pressure And Factors Affecting The Change In Blood Pressure For Korean Children: A Six-Year Follow-Up Study.
Il Suh, Soon Young Lee, Chung Mo Nam, Il Soon Kim
Korean J Prev Med. 1993;26(1):96-109.
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AbstractAbstract PDF
For the purposes of analyzing the distribution and the change in blood pressure according to age and determining the factors affecting the change in blood pressure, a follow-up study had been conducted for 6 years from 1986 to 1991 for 430 primary school children age 6 years old in 1986 in Kangwha County, Korea. The mean blood pressure increased according to age. Specifically mean systolic blood pressure increased from 97.3 mmHg for male and 96.4mmHg for female(at 6 years of age) to 108.8mmHg for male and 112.1mmHg for female(at 11 years of age). Mean diastolic blood pressure increased from 60.0mmHg for male and 61.8mmHg for female(at 6 years of age) to 72.9mmHg for male 73.8mmHg for female(at 11 years of age). The average annual increase in blood pressure was 2.3mmHg(in systolic blood pressure) and 2.4mmHg(in diastolic blood pressure) for female, respectively. To determine the factors affecting the change in blood pressure, the stepwise regression analysis was conducted. Children were divided into the three groups(low, middle, and upper) according to the level of systolic and diastolic blood pressure at the age of 6, and the regression analysis was performed in each group. For the change in systolic blood pressure, the changes in weight and skinfold thickness or initial skinfold thickness for male, and the change in weight for female were selected as significant factors for children in middle and upper group. For the change of blood pressure in diastolic blood pressure, no variables was significant.
Summary
A cohort study on the relationship between pesticide use and mortality, and cancer mortality.
Hee Chul Oh, Chung Mo Nam, Sun Hee Lee
Korean J Prev Med. 1991;24(3):390-399.
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The purpose of this study is to examine the relationship between pesticide use and mortality, and cancer mortality which are recognized as health hazards of pesticides. Data were analyzed from a cohort of 6,066 people aged fifty-five or over and who have been residing in the main island of Kangwha county. Death certificates, computerized citizenship registers searches, and household interview survey lead to get more than ninety-seven percents follow-up rate for the first five year observation period. Important findings are as follows: 1. Age specific mortality rates of pesticide users are significantly lower than those of pesticides nonusers. The SMR of male is 0.80, and 0.58 for females respectively probably due to healthy worker effects. But, age specific cancer mortality rates are significantly higher than those of pesticide nonusers (SMR=1.59) in males. this finding is not observed in females (SMR=0.85), however. 2. Logistic regression analyses showed that self-reported health status, drinking, and smoking histories in male are significantly associated with total mortality rate. The histories of pesticide use are also calculated to be highly associated with cancer mortality as in univariate analyses in males. In female, self-reported health status, age of first delivery are found to be significantly related to total mortality rate. Only drinking history is calculated to be associated with cancer mortalities in females. Data from further observation of 'Kangwha cohort' and indepth analyses of these are highly expected.
Summary
A quentitative model for the projection of health expenditure.
Han Joong Kim, Young Doo Lee, Chung Mo Nam
Korean J Prev Med. 1991;24(1):29-36.
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A multiple regression analysis using ordinary least square (OLS) is frequently used for the projection of healt expenditure as well as for the identification of factors affecting health care costs. Data for the analysis often have mixed characteristics of time series and cross section. Parameters as a result of OLS estimation, in this case, are no longer the best linear unbiased estimators (BLUE) because the data do not satisfy basic assumptions of regression analysis. The study theoretically examined statistical problems induced when OLS estimation was applied with the time series cross section data. Then both the OLS regression and time series cross section regression (TSCS regression) were applied to the same empirical data. Finally, the difference in parameters between the two estimations were explained through residual analysis.
Summary
The Change of Children's Blood Pressure and Factors Affecting the Level of Blood Pressure In Children.
Il Suh, Il Soon Kim, Chung Mo Nam, Soon Young Lee, Hee Chul Oh, Chun Bae Kim, Eun Cheol Park
Korean J Prev Med. 1989;22(3):303-312.
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To show the distribution and change of blood pressure according to age and find factors affecting the level of blood pressure in primary school children, a follow-up study was conducted from 1986 to 1989 on 401 first grade children attending primary school in Kangwha county in 1986 and their parents. The blood pressure of the children was significantly increased according to age. The average annual increase was 1.8mmHg in systolic blood pressure and 2.5mmHg in diastolic blood pressure. The level of blood pressure did not show any significant difference in both sexes. Among children who were at or above the 80th percentile of blood pressure in the first grade, 35 and 30% of them have remained at the same level of systolic and diastolic blood pressure respectively in the fourth grade. But we could not find any significance in the tracking of blood pressure of children who were at or above the 90th percentile of blood pressure in the first grade. Weight and pulse rate were shown to significant factors affecting systolic blood pressure in children of both sexes and mother's blood pressure and skinfolds thickness were also affected systolic blood pressure in girls. The variables significantly affecting diastolic blood pressure were arm circumference and pulse rate for boys and height and pulse rate for girls.
Summary
Occurrence of Pediatric Diseases in Relation to the Environment, Seasons and Atmospheric Phenomena(weather).
Duk Jin Yun, Kyung Sook Park, Han Kee Hwang, Chi Ok Ahn, Do Kwang Yun, Yung Jo Kwon, Dong Chul Park, Yong Hwang Yun, Chung Mo Nam
Korean J Prev Med. 1989;22(2):283-289.
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This study was conducted to investigate the association of the occurrence of pediatric disease with environmental, seasonal and atmospheric factors. The data were collected at 5 pediatric clinics in Seoul and the Department of Pediatrics of Yongin Severance Hospital from May 1986 to April 1987. The results were as follows: 1. Vacation periods had a great influence upon the occurrence of pediatric diseases. 2. The majority of pediatric diseases occurred mainly in spring and autumn, not in summer and winter. 3. The higher the average relative humidity was, the less diseases occurred; and the higher the maximum change of daily temperature, the more diseases occurred. 4. In summer, the pattern of diseases varied along with the environmental factors(eg., toilet).
Summary
Comparison and Analysis of the Results of Preventive Medicine Sutdy in a Medical College.
Seung Hum Yu, Jaehoon Roh, Sang Hyuk Jung, Chung Mo Nam
Korean J Prev Med. 1989;22(2):242-247.
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The purpose of this study was to find a better evaluation method by comparison and analysis of the subdivision-score for preventive medicine with other subjects and total score. Among the 475 students who were second grade in 1983, 1984 and 1985, we analyzed the scores for all subjects at Yonsei University College of Medicine obtained by 443 students, with the exception of 32 students who had a temporary absence from school, failed or had been expelled. And we analyzed the score for preventive medicine of 162 students who were second grade in 1987 and 179 students who were second grade in 1988. Statistical analysis of the above was done using the correlation analysis, chi-square test and discriminating index. The results were as follows: 1. The correlations of the subdivision of preventive medicine in 1984, 1987 and 1988 were statistical significantly high(r=0.36-0.56). 2. The grades obtained for preventive medicine and for other subjects except pediatrics (clerkship) were not independent. 3. The discriminating indices that determined whether or not a pertinent evaluation was made were 0.42 in 1983, 0.52 in 1984 and 0.54 n 1985. These results were classified as excellent. These results suggest that the score of a subject is determined not by the characteristics of the subject, but by the amount of personal study.
Summary
An Evaluation of a Patient Referral System using Intervention Analysis.
Woo Hyun Cho, Hae Jong Lee, Myongsei Sohn, Chung Mo Nam, Seung Hum Yu
Korean J Prev Med. 1989;22(2):236-241.
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The purpose of this study was to introduce the methodology of intervention analysis with time series data and to investigate the influence of the patient referral system on medical care utilization in Kangwha county. The data were obtained at the Kangwha Medical Insurance Society and we analysed the material based on the outpatient care fee. The results were as follows: 1. The average outpatient care utilization in the hospital decreased by 41.7% due to the patient referral system. 2. The utilization of the health institution increased by 278.8 persons per month due to the patient referral system. 3. The patient referral system did not influence the total outpatient care utilization. The methodology of intervention analysis, which detected the effect of intervention, will be helpful to the study of public health area.
Summary
JPMPH : Journal of Preventive Medicine and Public Health
© Korean Society for Preventive Medicine.
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