Mortality Patterns among Korean Vietnam Veterans / 대한산업의학회지

OBJECTIVES: A total of 320,000 Korean soldiers in three combat units and four supporting units participated in the Vietnam War. The aim of this study was to investigate the association between Vietnam experience and mortality by comparing mortalities in Korean Vietnam War veterans to the general population. METHODS: The deaths of 185,760 Vietnam veterans from January 1, 1992 to December 31, 2005 were confirmed by matching the veterans' information to death records from the National Statistical Office. Crude death rate, age adjusted rate and Standardized mortality ratios (SMRs) were calculated 95% confidence. Age was standardized to the total male population during 1992-2005 with the age of 36 to 83 years old. RESULTS: The age adjusted death rate per 100,000 was 868.1 among veterans and 1226.5 among the general population. Mortality of all causes was significantly lower among veterans (SMR=0.83, 95% CI: 0.82-0.84). Mortalities from neoplasms (SMR=0.87), circulatory diseases (SMR=0.79), and external causes of deaths (SMR=0.92) were significantly lower among veterans. Mortalities from several external causes of deaths including Intentional self-harm (X60-X84), assault and accidental poisoning, angina pectoris, chronic ischemic heart diseases, prostate cancer, and malignant neoplasms of hematopoietic system including multiple myeloma, non-Hodgkin's lymphoma, and leukemia were not different between veterans and the general population. CONCLUSIONS: Mortality among Vietnam veterans was lower than that among the general population. It would be explained mainly by healthy veteran effect.

An epidemiologic review of Japanese Encephalitis with a special focus on incidence and methods of control for South Korea / 한국역학회지

Japanese encephalitis(JE) is the leading viral cause of encephalitis and disability in Asia. The disease primarily infects children under the age of 15, leaving up to 70% of these who develop illness either dead or with a long-term neurological disability. We reviewed not only JE disease burden, etiology, vector, mode of transmission, reservoir but also geographic distribution and incidence of the disease in Asia, with a focus on the South Korea. A special comment on the methods of control JE and perspective for South Korea also included.

Prevalence And Management Status Of Diabetes Mellitus In Korea / 대한내과학회지

BACKGROUND: Through analyzing 1998 National Health Nutrition Survey (NHNS) data, we investigated the prevalence of diabetes mellitus (DM) and several basic factors reflecting the status of DM control: health behaviors, HbA1c level and the prevalence of hypertension among DM patients. METHODS: The NHNS selected 200 districts which represented the national population of Korea and surveyed all inhabitants within the districts. National Health Examination Survey (NHES) and National Health Behaviors Survey (NHBS) surveyed all inhabitants within the related districts. We analyzed the prevalence and management status of DM through analyzing the National Health Interview Survey (NHIS) data of 39,331 responders and NHES data of 10,876 participants. RESULTS: According to NHIS the prevalence of DM was 2.26% for male, 2.03% for female. 11.0% of DM patients exercised more than three times per week. 32.7% were current smokers. 43.1% were drinkers. 30.0% of DM patients had hypertension, but only 15.8% of them controlled blood pressure. From NHES the prevalence of DM was 9.73% for male, 7.95% for female. 10.5% of DM patients exercised more than three times per week. 36.5% were current smokers. 57.4% were drinkers. 45.3% of DM patients had >8% of HbA1c level. 38.1% of DM patients had hypertension, but only 5.3% of them properly controlled blood pressure. CONCLUSION: Considering the results of previous studies, the prevalence of DM have increased rapidly. The level of recognition of patients to control DM, however, was not enough to prevent late complications. Therefore national health policy should be reset to register DM patients and manage them properly.

Association between Quality of Life and Sexual Adjustment for Spinal Cord Injury Couples

OBJECTIVE: To examine the association between sexual adjustment and quality of life and to evaluate the difference of sexual adjustment between small group counselling program and simple sexual rehabilitation program for spinal cord injury couples. METHOD: Fifteen subjects who had participated in 4 weeks small group counselling and twenty subjects, who had participated in simple sexual rehabilitation education were enrolled among among spinal cord injury couples. Direct interview was conducted. Visual analogue scale, Time trade off, Hospital anxiety and depression, and Beck depression inventory were used as quality of life indexes. Sexual Interest, Activity and Satisfaction was used as a sexualadjustment measure. RESULTS: The sexual adjustment index was very significantly positively correlated with all 4 indexes of the quality of life. The couples of the small group counselling had significantly higher sexual adjustment index than the simple education group. Satisfaction for small group counselling was also higher. CONCLUSION: To improve the quality of life for spianl cord injury couples, sexual adjustment level must be improved. Systematic sexual rehabilitation program such as small group counselling may be better solution than simple sexual rehabilitation education program.

Cancer Incidence in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: We estimated the incidence of cancer in Korea. MATERIALS AND METHODS: The indicence of cancer was estimated using national mortality data, and the incidence data from four frontier regional cancer registries, including Kangwha, Seoul, Busan and Deagu. These four registries served a population about seventeen million, which is almost 38% of entire population in Korea. RESULTS: The overall age-standardized incidence rates (ASR) were 287.0 and 163.1 per 100,000 for males and females, respectively. Among males, stomach cancer was the most frequent (ASR 69.6), followed by lung cancers, including bronchus cancer (ASR 54.5), liver cancer (ASR 47.0) and colo-rectal cancer (ASR 25.2). The most frequent sites of cancer in females, by rank order, were stomach (ASR 26.8), breast (ASR 20.1), uterine cervix (ASR 18.0), colo-rectum (ASR 15.9), lung (ASR 13.0) and liver (ASR 12.0). CONCLUSION: It is hoped that these results will provide valuable leads for cancer research and cancer control in Korea.

A Study on Educational Accountability of Faculty in Medical Schools / 한국의학교육

PURPOSE: A college or university faculty can be regarded as an educator, researcher, and service provider. The purpose of this study is to evaluate the accountability of medical school professors focusing on the educational duties and to propose the solution and strategy for accountability evaluation of medical school faculty. METHODS: The study used questionnaires which was developed in five big categories asking basic information of the faculty, educational activities, subject of the accountability evaluation, and the primary disturbing factor in accomplishing the educational accountability. The questionnaires were asked to 61 faculty members in Yonsei University College of Medicine. RESULTS: The accountability importance of the medical school faculty was research(37.13%), teaching(31.80%), practice medicine(21.97%) and service(9.10%). Much weight was given for research(40.00%) and education(19.42%). The faculty concentrated mostly on delivering learning objectives as their educational activities. The biggest problem affecting the faculty from concentrating on educational accountability was the over workload. Insufficient incentives and lack of interest in education came next. The faculty also showed dissatisfaction with the obscurity of accountability assessment in operation, uniformity of the measurement and the absence of objective assessment standard. CONCLUSION: Medical schools need to create an environment in support of the faculty to focus on the educational activities. And when evaluating their accountability, the assessment standards need to be systematized and differentiated according to their specialities.

Some Aspects of the Education in Oriental Medicine

No abstract available.

A Neurocognitive Assessment: Mild Dementia of the Alzheimer Type, Questionable Dementia, and Non-Demented Elderly Women / 신경정신의학

The objective of this study is to differentiate the mild dementia of Alzheimer type from the questionable dementia and non-demented elderly using the neurocognitive assessment. Subjects of 28 women who were registered to kwangju Community Mental Health Center were as follows: 14 non-demented, 9 questionable dementia, 5 mild dementia of Alzheimer type. The diagnosis were made using DSM-IV, Clinical Dementia Rating Scale. The neurocognitive functions were assessed with following test tools 1) attention: Digit span, Visual span, Continuous attention; 2) memory: Logical memroy, Verbal paired associates-easy/hard 3) visual perception and visuospatial ability: Visual recognition test, Construction; and 4) language: Comprehension and Aphasia severity rating scale; 5) higher cortical function: Hypothesis formation, Perseveration, Similarity, Judgment, and Go-No-Go test. Group differences were analyzed with one way ANOVA test in SPSS 8.0 for win and LSD method as post-hoc analysis. The questionable dementia group showed significant difference in Verbal paired associateseasy pair, Construction, Aphasia severity rating scale and Similarity from the non-demented normal control group but showed no difference from the mildly demented group. These results suggest that the questionable dementia is actually very early or very mild stage of dementia of the Alzheimer type.

Therapeutic Effects of Psychosocial Programs in the Day Care Service on Cognitive Impairment and Depressive Symptoms in the Elderly Patients / 신경정신의학

Cognitive impairment and depression are the most common symptoms affecting the elderly on physical and mental states. Studies have shown that these symptoms in mild cases are improved by psychosocial intervention, emphasizing the importance of therapeutic intervention provided in the community. The purpose of this study was to investigate whether the psychosocial program at a geriatric day care service has any therapeutic effect on the cognitive function and depressive symptoms in the elderly and whether such effect can be maintained. The experimental group was composed of 37 elderly patients attending the day care service at the mental health center located in Kwangju county, Kyonggi province. The control group was composed of 22 elderly patients who either refused intervention or who dropped out of the program. Cognitive function was assessed with the Korean version of the Mini-Mental State Exam(MMSE-K) and depressive symptoms were assessed with the Short-form Geriatric Depression Scale(SGDS) The experimental group and the control group were compared on the score of on each test, which was administered before and after the program and 10 weeks after discontinuation of program. In the experimental group, the scores acquired immediately after the program and at 10 weeks of follow-up were also compared. The results showed that psychosocial intervention at a geriatric day care service was significantly associated with the change in SGDS scores dependent on time but not significantly associated with the change in MMSE-K scores. In the experimental group whose follow-up assessment was possible, it was further shown that 43% of patients had increased SGDS scores 10 weeks after the program ended, indicating that depressive symptoms had worsened. This study suggests that psychosocial therapeutic intervention in the geriatric day care service improve depressive symptoms but not cognitive functions in the elderly. In addition, for a considerable percentage of subjects in the experimental group, the improvements in depressive symptoms were not sustained after the intervention was withdrawn. These findings proposes a need of strengthening therapeutic intervention to maintain such effect.

Psychosocial Aspects of Obse Adolescents

BACKGROUND: The prevalence of adolescent obesity is so rapidly increasing in Korea that there are concerns not only for increased risk of adult obesity in the future, but also for psychosocial problems in this period. This study is to find out the psychosocial correlates of adolescent obesity such as demographic characteristics, concerns about body image and weight, self-esteem, depression, and the locus of control for obesity. METHODS: A total of 963(obesity, 433 ; normal weight, 530) among 8,209 students from schools that underwent survey of physlcal examination in Seoul were assessed with a self-administered questionnaire. RESULTS: There were stastically significant differences between the obese group(OG) and the normal weight group(NWG) in family structure(p<0.05) and economic status(p<0.01). Adolescents in a extended family were more frequent in the OG(14.3%), than in the NWG( 9.4% ). Those in the high economic status were less frequent in the OG(15.3% ) than in the NWG (23.8% ), Although almost all obese adolescents considered that they were fat, normal weight students did not view themselves as they really were(p<0.001). That is, 57.5% of the NWG thought that they were either fat or thin instead. The majority of the OG was not satisfied with (86.4%) and was worried(88.0%) about their weight(p<0.001), and these aspects were more remarkable in women(p<0.001). The total self-esteem score in the OG was higher(p<0.001) than the NWG, and the depression score was lower in the OG than the NWG(p<0.001). Higher scores for powerful others and chance in the OG than those in NWG were shown(p<0.001). The psychosocial aspects which were highly associated with obesity were self-esteem in peers (odds ratio=1.547) and school(odds ratio=2.041), and powerful others(odds ratio=2.181) and chance(odds ratio=2.367) locus of control for obesity, and less probable characteristics were depression(odds ratio=0.723) and high economic status(odds ratio=0.498). CONCLUSIONS: Obese adolescents neither had low self-esteem nor were they depressive to the contrary of belief in the general public. Since they were not satisfied with and were worried about their body weight, however, there is a need to change our misconception of obese people who may risk unhealthy weight reduction. Further studies using various instruments and reinforcing internality for management of obesity would be needed to deeply understand the psychosocial correlates of obesity.

A Study on the Relationship Between Smoking Habits and BMI of Adult Males / 한국역학회지

Smoking, obesity and diet are just a few of the multifactors which have been suggested to be associated with the risk of CHD. It is a common phenomenon that persons who stop smokin gain weight. This fear of gaining weight is often given as a reason for giving up to quit smoking. The purpose of this study is to find the effects of cessation of smoking on body weight and the difference of BMI distribution according to smoking habits. The subjects of this study were 72 techinical high school teachers in Seoul and Kyounggi-Do, 85 offical wokers of the S-Company and 81 auto industrial workers in PyoungTaek. The investigation for this study has been conducted from Oct. 27th to Oct. 31st 1997. The method was self-feported questionnaire survey which consists of general characterisics, smoking habits and its relevant questions. The questionnaires were revised after two-times of pre-tests, carried out for twenty subjects. The results are as follows ; 1. Smoking habits have significant relations with diet, exercise, drinking and the amount of daily smoking. 2. BMI among different smoking habits groups showed significant differences in following variables ; age, the interaction between exercise and smoking habits, drinking level, the interaction etween drinking level and smoking habits and the interaction between total smoking duration and smoking gabits. 3. The mean values of BMI are 23.5 in non-smoker, 23.8 in ex-smoker and 23.4 in current smoker. There are no statistically significant differencs among amoking habits. 4. The average of 2.14kg weight gain is witnessed after 6 months of the cessation of smoking. Current weight was high by 3.89kh in average compared to the pre-cessation weight(p=0.0001). 5. The odds ratio for gaining weight among ex-smokers is 8.94 in "increase or very increase" group in diet compared to those of "no change". 6. The multiple regression analysis has a significant model in current smoker(p=0.001). The mean BMI of those who were "very active" in exercise is higher than that of "inactive" or "active". The mean BMI of those who were "light or moderate ot heavy drinker" is lower than that of "non-drinker". The mean BMI of those who have the monthly income 1.5millions-1.99millions won is significantly higher than those having less than 1.5millions or more than 2.0millions won. The implication of this study could suggest that health education for smoking cessation needs new approches to minimize weight gain.

An Epidemiologic Investigation of Typhoid Fever Outbreak in Pusan, 1996 / 한국역학회지

An epidemiologic investigation was carried out to identify the source of infection of typhoid fever outbreak, which was occurred in Nam-Gu, Pusan city from April 20 to June 28, 1996. The distribution of 83 reported cases (55 confirmed cases and 28 suspected cases) by sex and age group showed that this epidemic would be occurred by the exposure to a common source with low toxic pathogen because 55.4% of cases were under 20 years old and most of the adults cases were female. The epidemic curve showed a unimodel curve with a peak on about 15 May and tailed down to 23 June, suggesting that the exposure was constant. These results supposed that the contamination of a public water supply would be the source of infection. The analysis of reported cases and population survey conducted to household members and community contacts living in the epidemic area, led the conclusion that the source of infection was tap water supplied through the Dae Youn pumping station, based on the following findings: (1) There were singificant differences of incidence rate among regions (Tong) even though in the same Dong and the spot map of incident cases distributed in accord with the water supply by Dae-Youn pumping station. (2) Among reported cases, 21 cases, including 17 confirmed cases, stated they had used only tap water. (3) The analysis of tap water from the house which had seven typhoid cases, revealed the contamination of E coli and the dilution of residual chlorinated concentration. (4) The outbreak of typhoid fever was stopped after the replacement of The worn-out pipe line of tap water supply to the new one.

A Study on the Effect of Symptoms to Diagnosis Interval on the Cancer Survival / 한국역학회지

For many years, members of medical profession have believed that the shorter symptoms to diagnosis interval(SDI) might be related to early stages and that the prompt treatments might improve survival rates in cancer patients. But this notion has been challenged by many researches for many years. This study was conducted to investigate the effects of SDI on the cancer survival for 221 stomach cancer cases, 106 lung cancer cases, 74 liver cancer cases and 59 cervix cancer cases. These cancer cases are registered ones in Kanghwa Cancer Registery Program from 1987 to 1991. Relationships among SDI, stages of cancers, operation rates, and survival were analysed. Results are as follows: 1. SDI was not related to stages of cancer. There were no difference in the distribution of stages among five SDI subgroups. 2. This data did not support that SDI affects the survival of stomach cancer patients. The cancer stages did affect survival in stomach cancer patients though. 3. Our data did not support that SDI affects cancer survival. A Cox proportional hazard model showed that SDI does not play a important role in cancer survival controlling age, gender, stage and other variables in the model. Further studies are highly expected to clarify the relationships between SDI and cancer survivals. Researches with bigger sample size and more sophisticated variables would be needed.

A Study on the Source of Cholera Epidemic of Korea 1995-1996 / 한국역학회지

E1 tor cholera epidemic have been reported eight times in Korea since 1963. Researchers suspected unattempted importation of cholera bacteria from foreign countries or artificial germination by some people. No researchers have made hypotheses of environmental reservoir as the sources of cholera epidemics until in 1991 in Korea. This study focuses on the aquatic reservoir as the potential source of cholera epidemic. A total of 68 cholera patients were noted in 1995 and only two in 1996. Authors argue for aquatic reservoir as the source of 1995, 1996 cholera epidemic and designate sea fishes as the vehicle of cholera infection The national Institute of Health team cultured Vibrio cholera O1, from the samples of sea water from Kangwha county in September 1995. The sporadic Occurrence of cholera patients around the country who have not traveled out of town support aquatic environmental reservoir as the source of 1995, 1996 cholera epidemic in Korea.

Comparisons of cholera bacilli positive and negative patients in symptoms and laboratory findings among 1991 cholera patients / 한국역학회지

Among 130 cholera patients treated in Seohae Hospital in 1991, 86 were cholera bacilli positive and remaining 44 were negative. All cholera bacilli 'positive' patients were confirmed bacteriologically by National Institute for Health team. Cholera related symptoms and laboratory findings were gathered by interviews and medical records surveys. Symptoms and some serological laboratory findings are compared between cholera bacilli 'positive' and 'negative' patients in 1991 cholera epidemic. Results are as follows: 1. There were no differences in symptoms distribution and in mean values of all serological laboratory tests done between two groups. These facts support that both cholera bacilli 'positive' and 'negative' patients are persons who have cholera bacilli infection. 2. The age distribution of the cholera bacilli 'negative' group tended to be much younger than that of 'positive' group. The infection source of this group is believed to be the environmental reservoir. This findings suggests that cholera bacilli 'negative' patients have the possibility of endemic characteristics. We think it is worth investigating Vibrio cholera antibody titers of people in area with frequent cholera epidemics in Korea.

A Case-control Study of Risk Factors in Stomach Cancer / 한국역학회지

Stomach cancer is the most common cancer in Korea with highest mortality. Therefore, finding risk factors involved in its prevention is vitally important. Case-control study was done to demonstrate the relationship between smoking, drinking, food, nutrition, 5% salt solution and the incidence of stomach cancer. The study group consisted of 82 patients with stomach cancers confirmed by pathology as case group and 113 patients with chronic superficial gastritis as control. General characteristics, smoking and drinking habits, dietary habit according to food groups, individual preference to salty and spicy foods were analyzed. Subjects had undergone taste test with 10cc of 0.5% salt solution. Age adjusted odds ratios by Mantel-Haenszel test were performed for each variable. 1. Smoking in males had no direct relationship with incidence of stomach cancer, but in females there is a higher odds ratio in smoking group (OR=2.63). Drin-king had no effect on the odds ratio in males, whereas in females, the odds ratio was significantly decreased in drinking group (OR=0.25). 2. Consumption of fruits in females showed a protec-tive effect on developing stomach cancer (OR=0.41). Males who had more protein and iron intake were found to have significantly higher odds ratio for stomach cancer risk (protein OR=2.86, iron OR=5.18). 3. Salty diet habit in females showed a higher odds ratio for stomach cancer risk (OR=2.49). No correlation was found between spicy diet habit with stomach cancer. 4. Male subjects who did not feel salty with 0.5% salt solution showed significantly increased odds ratio (OR=4.59) for stomach cancer. This study is limited due to fact that the number of subjects was not large enough for indepth evaluation and that other confounding factors other than age was not sufficiently controlled. Further investigation that concerns ingestion of fruit group, the level of subjects' taste to 0.5% salt solution, and protein and iron intake on a larger scale is recommended.

Self Rated Health and Mortality in Elderly Kangwha Cohort, 8-year follow up / 한국역학회지

The effect of self rated health on all cause mortality was. examined in a community residents sample of 2, 848 men and 3, 534 women aged 55 years or over who has been followed for eight years, 1985-1993. This longitudinal study, conducted in Kangwha County, Keanggido, began in 1985 with baseline examinations of physical and life style characteristics. The results indicate that the self-rated health has a profound and independent effect on all cause mortality during the study period. Cox's hazard model estimates that persons with 'poor' self-rated health has 1.7 times (CI 1.2-2. 6) higher risk of all cause mortality than persons with 'excellent' self-rated health and persons with 'worst' one has 4.2 (CI 2.6-6.2) in male. Estimates for women are similar to those of men. Further researchs to investigate the effects on cause specfic mortality and effects to reveal the work mechanism of self-rated health are highly expected.

A study on the nondifferential misclassification-a mathematical approach for correcting the estimates- / 한국역학회지

No abstract available.

Lifestyle / 예방의학회지

This article reviewed the historic and epidemiologic reasons for the emergence of health promotion with a special focus on lifestyle. Health effects of tobacco, alcohol, physical exercise, and nutrition were briefly presented by reviewing recent researches. Social environments supposed to limit the application of health promotion strategies are also mentioned.