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Volume 39(3); May 2006
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English Abstracts
Directions for Future Development of Preventive Medicine in Korea.
Joon Youn Kim
J Prev Med Public Health. 2006;39(3):185-189.
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  • 39 Download
AbstractAbstract PDF
It is the actual state of the medical society in our country that many graduates of medical schools want to be clinicians, and accordingly Korea's medical situation is relatively too focused on curative medicine. However, this situation is changing due to several factors including a growing number of doctors, inappropriate regulations for medical fees, changes in social status of doctors themselves, and excessive competition between doctors. Furthermore, we expect more advances in medical field of Korea since Korean government started to attach great importance to sciences and produced policies to support sciences, and as a result, more and more interest and effort in the fields of basic research including preventive medicine is being attached especially by young doctors as compared against the past. However, decline of clinical medicine fields doesn't always mean bright future for the field of preventive medicine. True future is possible and meaningful only when we prepare for it by ourselves. In other words, as the promising future is closed to one who spares no effort, we shouldn't fear to oppose unknown challenges and simultaneously need to support colleagues who bear such a positive mind. It is the most important thing for our preventive medicine doctors to evaluate the past and the present of preventive medicine and to foster a prospective mind to prepare for the future of preventive medicine. I set forth my several views according to directions for the development of preventive medicine which we already discussed and publicized in the academic circle of preventive medicine. Those directions are recommen dation of clinical preventive medicine, promotion of preventive medicine specialty, fostering the next generations, improving the quality of genetic epidemiologic study, participation in control of environmental pollution and food safety, contribution to chronic disease control, and preparation to role in medical services for unified Korea.
Summary
Perspectives of Preventive Medicine: Focused on Epidemiology.
Jin Su Choi
J Prev Med Public Health. 2006;39(3):190-194.
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AbstractAbstract PDF
Epidemiology is the key element of public health and preventive medicine. Reversely, public health and social equity are the basic ground for epidemiologists. Current progress in the various fields of epidemiologic study in Korea calls for the increased participation of the trained epidemiologists. Expanding epidemiologic concepts to the wide spectrum of health and medical programs, active participation to the diversified health service fields and strengthening the role of epidemiology in the social and political decision making should be included in the perspectives of epidemiology in Korea. The future of epidemiology is certainly depend on the efforts of present epidemologists.
Summary
Vision and Training Strategy for Health Management Specialist.
Han Joong Kim
J Prev Med Public Health. 2006;39(3):195-198.
  • 1,875 View
  • 31 Download
AbstractAbstract PDF
The identity crisis of preventive medicine appears to have been deepening. As a solution, it is insisted that preventive medicine should focus on clinical preventive medicine. However, in the field of heath policy and management, the better solution should be found in a serious search for visions and perspectives of its study on population and society. In this regard, the specialist who studies the field can be defined as a medical doctor majoring in public health. In this paper, I first forecasted major socioeconomic changes to occur in medical and public health arena and explored the role of those studying health policy and management. Secondly, I summarized their career paths and main activities in order to establish visions. Finally, I proposed curriculums on health policy and management for medical school undergraduates and for specialists majoring in preventive medicine, respectively.
Summary
Mercuric Chloride Induces Apoptosis in MDCK Cells.
Ju Hyoung Lee, Jung Ho Youm, Keun Sang Kwon
J Prev Med Public Health. 2006;39(3):199-204.
  • 2,075 View
  • 63 Download
AbstractAbstract PDF
OBJECTIVES
Mercury is a hazardous organ-specific environmental contaminant. It exists in a wide variety of physical and chemical states, each of which has unique characteristics for the target organ specificity. Exposure to mercury vapor and to organic mercury compounds specifically affects the CNS, while the kidney is the target organ for inorganic Hg compounds. METHODS: In this study, mercury chloride (HgCl2) was studied in a renal derived cell system, i.e., the tubular epithelial Madin-Darby canine kidney (MDCK) cell line, which has specific sensitivity to the toxic effect of mercury. MDCK cells were cultured for 6-24 hr in vitro in various concentrations (0.1-100 M) of HgCl2, and the markers of apoptosis or cell death were assayed, including DNA fragmentation, caspase-3 activity andwestern blotting of cytochrome c. The influence of the metal on cell proliferation and viability were evaluated by the conventional MTT test. RESULTS: The cell viability was decreased in a time and concentration dependent fashion: decreases were noted at 6, 12 and 24 hr after HgCl2 exposure. The increases of DNA fragmentation were also observed in the concentrations from 0.1 to 10 M of HgCl2 at 6 hr after exposure. However, we could not observe DNA fragmentation in the concentrations more than 25 M because the cells rapidly proceeded to necrotic cell death. The activation of caspase-3 was also observed at 6 hr exposure in the HgCl2 concentrations from 0.1 to 10 M. The release of cytochrome c from the mitocho-ndria into the cytosol, which is an initiator of the activation of the caspase cascade, was also observed in the HgCl2-treated MDCK cells. CONCLUSIONS: These results suggest that the activation of caspase-3 was involved in HgCl2-induced apoptosis. The release of cytochrome c from the mitochondria into the cytosol was also observed in the HgCl2-treated MDCK cells. These findings indicate that in MDCK cells, HgCl2 is a potent inducer of apoptosis via cytochrome c release from the mitochondria.
Summary
Public Perceptions of the Risk of Asian Dust Storms in Seoul and its Metropolitan Area.
Hyoung June Im, Ho Jang Kwon, Mina Ha, Sang Gyu Lee, Seung Sik Hwang, Eun Hee Ha, Soo Hun Cho
J Prev Med Public Health. 2006;39(3):205-212.
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  • 62 Download
AbstractAbstract PDF
OBJECTIVES
In spite of the recent increased concern for Asian dust storms, there are few studies concerning how dangerous the general public recognizes these dust storms to be. This study examined the public's perceptions of the risk of the Asian dust storms and also the source of the information concerning the risk. METHODS: A telephone interview survey using a standardized questionnaire was done for the adults living in Seoul and its metropolitan area from May 15th, 2003 to May 16th, 2003. The contents of the questionnaire were the sociodemographic characteristics, the perceptions of risk to the Asian dust storms, and the coping strategy of the study participants. RESULTS: The study participants get their information on Asian dust storms mainly from TV newscasts and they have a good knowledge of them. They regard it as one of the most dangerous health risks, along with dioxin. They think that it is associated with allergic rhinitis, conjunctivitis and bronchial asthma, etc. Of the 500 study participants, 201(40.2%) persons suffered bodily discomforts during the Asian dust storm period. CONCLUSIONS: Although there are uncertainties about the health risks of Asian dust storms, the public thinks these dust storms are very dangerous to health in many ways. This negative perception will not disappear easily. To fill the gap of the public's perceptions of the risk and the objective evidence of its health effects, more studies about its health effects and the methods to reduce exposure are required.
Summary
Effects of the Late Marriage of Korean Women on the First-birth Interval.
Woojin Chung, Kyoungae Lee, Sunmi Lee
J Prev Med Public Health. 2006;39(3):213-220.
  • 2,160 View
  • 79 Download
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to examine the effect of women's late age of marriage on the interval between marriage and their first birth. METHODS: Data from Year 2000 Korea National Fertility Survey was collected through direct interview questionings, and the data was analyzed based on randomly selected sampling. In particular, the married women (N=5,648) were analyzed for the factors that determined the first-birth interval by performing Cox's proportional hazard model survival analysis. RESULTS: Unlike previous findings, the woman whose age of marriage was 30 or more was more likely to delay the birth of her first baby than were the other women who married earlier. Further, a woman's age at marriage, a woman's residence before marriage, her husband's religion, her husband's level of education and the difference in age between the woman and her husband significantly influenced the first-birth interval. In contrast, for a married woman, her age, level of education, current residence and religion were not significant predictors of her first birth interval. CONCLUSIONS: Our study showed that women who married at the age of 30 years or more tend to postpone their first birth in Korea. When facing the increasing number of women who marry at a late age, the Korean government should implement population and social policies to encourage married women have their first child as early as possible.
Summary
Original Article
A Longitudinal Study of the Relationship Between Health Behavior Risk Factors and Dependence in Activities of Daily Living.
Sang Hyuk Jung, Truls Oslash stbye, Kyoung Ok Park
J Prev Med Public Health. 2006;39(3):221-228.
  • 2,261 View
  • 102 Download
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. METHODS: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non-Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. RESULTS: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. CONCLUSIONS: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.
Summary
English Abstracts
The Incidence and Risk Factors of Hypertension that Developed in a Male-workers' Cohort for 3 Years.
Hyun Ju Seo, Soo Geun Kim, Chong Soon Kim, Yun Kyun Chang, Il Geun Park
J Prev Med Public Health. 2006;39(3):229-234.
  • 2,479 View
  • 55 Download
AbstractAbstract PDF
OBJECTIVES
Cardiovascular disease is one of the main causes of death and morbidity in Korea. In this study, the prevalence and incidence of developing hypertension in a male-workers' cohort were investigated during 3-years follow-up with a view to find the risk factors that affected the development of hypertension. METHODS: Among the 5,374 people who participated in a routine health check up, 3,852 people with normal blood pressure and who had no history of hypertension were prospectively followed up for 3 years. The classification of hypertension was based on the JNC7 report (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). Life style factors and underlying diseases that were related to the risk factors of hypertension were collected by using a self-report questionnaires via the internet. RESULTS: The prevalence of hypertension was 28.3% (1,520/5,374) at the first screening (2001). It was found that the incidence in 2004 of hypertension for the follow-up subjects (3,711) who had normal blood pressure in 2001 was 7.6 per 100 person-year. Multiple logistic regression analysis of the variables related to the risk factors of hypertension was carried out. The relative risks were 1.037 (95% CI=1.022-1.053) as the age increased 1 year and 1.039 (95% CI=1.023-1.055) as the body mass index increased 1 kg/m2. The relative risk for the prehypertensive group was 2.501(95% CI=1.986-3.149) compared to the normotensive group. These results showed that age, body mass index and the baseline blood pressure were significantly related to the incidence of hypertension. CONCLUSIONS: The incidence of hypertension was 7.6 per 100 person-year during follow-up. It was concluded that the risk factors for developing hypertension in the short-term were age, BMI, and prehypertension; Especially, this showed that it is necessary for prehypertensives to manage their body weight and blood pressure to prevent hypertension in middle-age by modifying their life style.
Summary
Clustering of Metabolic Risk Factors and Its Related Risk Factors in Young Schoolchildren.
Kyoung Ae Kong, Bo Hyun Park, Jung Won Min, Juhee Hong, Young Sun Hong, Bo Eun Lee, Namsoo Chang, Sun Hwa Lee, Eun Hee Ha, Hyesook Park
J Prev Med Public Health. 2006;39(3):235-242.
  • 2,472 View
  • 37 Download
AbstractAbstract PDF
OBJECTIVES
We wanted to determine the distribution of the clustering of the metabolic risk factors and we wanted to evaluate the related factors in young schoolchildren. METHODS: A cross-sectional study of metabolic syndrome was conducted in an elementary school in Seoul, Korea. We evaluated fasting glucose, triglyceride, HDL cholesterol, blood pressures and the body mass index, and we used parent-reported questionnaires to assess the potential risk factors in 261 children (136 boys, 125 girls). We defined the metabolic risk factors as obesity or at risk for obesity (> or = 85th percentile for age and gender), a systolic or diastolic blood pressure at > or = 90th percentile for age and gender, fasting glucose at > or = 110 mg/dl, triglyceride at > or = 110 mg/dl and HDL cholesterol at @40 mg/dl. RESULTS: There were 15.7% of the subjects who showed clustering of two or more metabolic risk factors, 2.3% of the subjects who showed clustering for three or more risk factors, and 0.8% of the subjects who showed clustering for four or more risk factors. A multivariate analysis revealed that a father smoking more than 20 cigarettes per day, a mother with a body mass index of = 25 kg/m2, and the child eating precooked or frozen food more than once per day were associated with clustering of two or more components, with the odds ratios of 3.61 (95% CI=1.24-10.48), 5.50 (95% CI=1.39-21.73) and 8.04 (95% CI=1.67-38.81), respectively. CONCLUSIONS: This study shows that clustering of the metabolic risk factors is present in young schoolchildren in Korea, with the clustering being associated with parental smoking and obesity as well as the child's eating behavior. These results suggest that evaluation of metabolic risk factors and intervention for lifestyle factors may be needed in both young Korean children and their parents.
Summary
Comparative Study
A Preliminary Study on the Korean Version of Quality of Life-Alzheimer's Disease (QOL-AD) Scale in Community-dwelling Elderly with Dementia.
Hee Young Shin
J Prev Med Public Health. 2006;39(3):243-248.
  • 2,488 View
  • 103 Download
AbstractAbstract PDF
OBJECTIVES
The Quality of Life-Alzheimer's Disease (QOL-AD) scale is a reliable and valid tool for assessing the quality of life (QOL) in the elderly with dementia. This study aimed to develop the Korean version of Quality of Life-Alzheimer's Disease (KQOL-AD) scale for the demented elderly living in the community. METHODS: KQOL-AD was administered to two groups: 24 demented elderly and 72 cognitively impaired elderly with no dementia (CIND) who were living in the community. Each elderly person and their caregiver rated the elderly QOL. The Korean version of mini-mental state examination (MMSE-K), the clinical dementia rating (CDR), the activities of daily living (ADL), and the neuropsychiatric inventory (NPI) were also assessed. The reliability and validity of the KQOL-AD were examined. RESULTS: In the dementia group, the internal consistency (Cronbach's alpha), the split half and the test-retest reliabilities of the KQOL-AD were excellent. Scores on the KQOL-AD were significantly correlated with the scores of the NPI, but they were not significantly correlated with scores of the MMSE-K, CDR and ADL. In addition, the CIND group showed similar results to the dementia group. CONCLUSIONS: KQOL-AD might be a reliable and valid instrument for assessing QOL in the elderly with dementia. It could be used as an important outcome measure for research on the demented elderly.
Summary
English Abstracts
Factors Associated with Perceived Peer Smoking Prevalence among Adolescents.
Soon Woo Park, Sang Won Lee, Jong Yeon Kim, Jung Han Park
J Prev Med Public Health. 2006;39(3):249-254.
  • 2,257 View
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to examine the factors related to the perceived peer smoking prevalence for adolescents. METHODS: A self-administrated questionnaire was administered to 352 students in a technical high school in Kangwon Province in May, 2002. The questions included in the questionnaire were concerned with the estimated number of smokers among ten students of the same grade in their school, the sociodemographic characteristics, the smoking-related behaviors and attitudes, and the smoking-related environments. All the students had their expiratory carbon monoxide level measured with EC50 Micro-Smokerlyzer? to verify their smoking status. Multiple regression analysis was applied for data analysis using Windows SPSS 11.5. RESULTS: The former and current smokers overestimated the peer smoking prevalence. Multiple regression analysis for estimating the peer smoking prevalence for the male showed that the perceived smoking prevalence was higher in the female students than in the male students, higher in those students whose mothers had a higher educational level, who had smoked more frequently, who had more best friends smoking, and who had a higher actual smoking rate of the class. For estimating the peer smoking prevalence for the female, the perceived smoking prevalence was higher in the female students than in the male students, higher in those who smoked more frequently, whose five best friends smoked, who had higher actual smoking rate of the class, and who had smoking siblings. CONCLUSIONS: This study showed that a higher perceived peer smoking rate is related with their own smoking history and smoking frequency, the smoking related environment, and gender. Smoking prevention and smoking cessation programs need to focus on correcting the falsely perceived smoking prevalence.
Summary
A Study on the Incidence of Cancer and Evaluationg the Quality of the Community-based Cancer Registry in Gwangju Metropolitan City during the First Five Years of Implementation (1998-2002).
Su Jin Lee, Min Ho Shin, Jin Su Choi
J Prev Med Public Health. 2006;39(3):255-262.
  • 2,181 View
  • 33 Download
AbstractAbstract PDF
OBJECTIVES
This study is conducted to identify the cancer incidence in Gwangju during the 5-year period from 1998 to 2002 and to assess the completeness and validity of the cancer registry data during this time period. METHODS: All cases that had a diagnosis of invasive cancer (ICD-10 sites C00-C97) during the study period were retrieved from the records of the Gwangju Cancer Registry (GCR), which theoretically includes all the cancer cases in Gwangju. All the cases during the study period were analyzed by gender, age group and cancer sites. The completeness (mortality/incidence ratio and age-specific incidence curve) and validity (histologic verification, primary site unknown, age unknown and death certificate only) of the cancer registry in Gwangju were analyzed by gender, age group and cancer sites for the 5-year period. RESULTS: The overall cancer incidence was higher in the males than in the females (age-standardized incidence rates (ASR) 299.8 and 172.4 per 100,000, respectively). In males, the most common cancer was stomach (ASR: 65.8), followed by liver (ASR: 50.5), bronchus and lung (ASR: 50.5), colo-rectum (ASR: 26.7), oesophagus (ASR: 10.6), and bladder (ASR: 10.3) in descending order. In females, the most common cancer was stomach (ASR: 26.8), followed by thyroid (ASR: 20.7), breast (ASR: 20.4), cervix uteri (ASR: 14.3), bronchus and lung (ASR: 13.0), liver (ASR: 10.7) and colo-rectum (ASR: 17.2) in descending order. The overall quality (completeness and validity) of the cancer registry was at the inigood'level. CONCLUSIONS: These results will be useful in the overall context of planning and evaluating of cancer control activities in Gwangju.
Summary
The Continuum of Rehabilitation Care and the Rehabilitation Services that are Needed by People with Severe Disabilities.
Soong Nang Jang, Seonja Rhee, Wan Ho Kim, Kyu Beom Lee, Sukyung Kim, Jae Young Lim
J Prev Med Public Health. 2006;39(3):263-269.
  • 2,079 View
  • 60 Download
AbstractAbstract PDF
OBJECTIVES
As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. METHODS: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care. RESULTS: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. CONCLUSIONS: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.
Summary

JPMPH : Journal of Preventive Medicine and Public Health