• Journal of Preventive Medicine and Public Health
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• 제43권2호
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• pp.185-192
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• 2010

Objectives: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. Methods: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. A publication bias was tested for using Egger's test. The homogeneity test was performed before the integration of each of the standardized mortality ratios (SMRs) and the result proved that the studies were heterogeneous. Results: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. Conclusions: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7941-7945
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• 2014

Catechol-O-methyltransferase (COMT) is involved in estrogen metabolism and is vital to estrogen-induced carcinogenesis, including that of ovarian cancer. Although many recent epidemiologic studies have investigated associations between the COMT rs4680 polymorphism and ovarian cancer risk, the results remain inconclusive. We therefore performed a meta-analysis to derive a more precise estimate of associations. Systematic searches of the PubMed, Embase, Web of Science, Cochrane Library, Wanfang, China National Knowledge Infrastructure, and Chinese Biomedicine databases were undertaken to retrieve eligible studies. Odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were pooled to assess the strength of the association. In total, 8 case-control studies involving 1,293 cases and 2,647 controls were included in the meta-analysis. Overall, the results showed no evidence of significant association between the COMT rs4680 polymorphism and ovarian cancer risk in any of the assessed genetic models. Subgroup analyses by ethnicity also did not reveal any significant association in any genetic model (p>0.05). In conclusion, our findings suggest that the COMT rs4680 polymorphism may not contribute to the risk of ovarian cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3117-3121
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• 2013

Objective: Previous epidemiologic studies demonstrated that obesity might associated with the risk of bladder cancer. However, many of the actual association findings remained conflicting. To better clarify and provide a comprehensive summary of the correlation between obesity and bladder cancer risk, we conducted a meta-analysis to summarize results of studies on the issue. Stratified analyses were also performed on potential variables and characteristics. Methods: Studies were identified by searching in PubMed and Wanfang databases, covering all the papers published from their inception to March 10, 2013. Summary relative risks (SRRs) with their corresponding 95% confidence intervals (CIs) were calculated by either random-effect or fixed-effect models. Results: A total of 11 cohort studies were included in our meta-analysis, which showed that obesity was associated with an increased risk for bladder cancer in all subjects (RR=1.10, 95% CI=1.06-1.16; p=0.215 for heterogeneity; $I^2$=24.0%). Among the 9 studies that controlled for cigarette smoking, the pooled RR was 1.09 (95% CI 1.01-1.17; p=0.131 for heterogeneity; $I^2$=35.9%). No significant publication bias was detected (p = 0.244 for Egger's regression asymmetry test). Conclusions: Our results support the conclusion that obesity is associated with the increased risk of bladder cancer. Further research is needed to generate a better understanding of the correlation and to provide more convincing evidence for clinical intervention in the prevention of bladder cancer.

• Parasites, Hosts and Diseases
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• 제46권3호
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• pp.157-164
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• 2008

Three Acanthamoeba isolates (KA/E9, KA/E17, and KA/E23) from patients with keratitis were identified as Acanthamoeba triangularis by analysis of their molecular characteristics, a species not previously recognized to be a corneal pathogen. Epidemiologic significance of A. triangularis as a keratopathogen in Korea has been discussed. Morphologic features of Acanthamoeba cysts were examined under a microscope with differential interference contrast (DIC) optics. Mitochondrial DNA (mtDNA) of the ocular isolates KA/E9, KA/E17, and KA/E23 were digested with restriction enzymes, and the restriction patterns were compared with those of reference strains. Complete nuclear 188 and mitochondrial (mt) 16S rDNA sequences were subjected to phylogenetic analysis and species identification. mtDNA RFLP of 3 isolates showed very similar patterns to those of SH621, the type strain of A. triangularis. 16S and 18S rDNA sequence analysis confirmed 3 isolates to be A. triangularis. 18S rDNA sequence differences of the isolates were 1.3% to 1.6% and those of 16S rDNA, 0.4% to 0.9% from A. triangularis SH621. To the best of our knowledge, this is the first report, confirmed by 18S and 16S rDNA sequence analysis, of keratitis caused by A. triangularis of which the type strain was isolated from human feces. Six isolates of A. triangularis had been reported from contaminated contact lens cases in southeastern Korea.

• Journal of Korean Academy of Nursing
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• 제53권1호
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• pp.12-27
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• 2023

Purpose: This study aimed to develop a scale to measure distress in patients with ischemic stroke and verify its validity and reliability. Methods: Preliminary items were developed from literature review and in-depth interviews. The final preliminary scale was confirmed through a content validity test of eight experts and a preliminary survey of 10 stroke patients. The participants for psychometric testing were 305 stroke patients in the outpatient clinic. Validity and reliability analyses included item analysis, exploratory and confirmatory factor analysis, convergent validity, known-group validity, and internal consistency of the scale. Results: The final scale consisted of 17 items and 3 factors. The three distinct factors were 'self-deprecation, worry about future health, and withdrawal from society' and this structure was validated using a confirmatory factor analysis. Convergent validity was supported by comparison with the Center for Epidemiologic Studies Depression Scale (r = .54, p < .001) and Brief Illness Perception Questionnaire (r = .67, p < .001). Known-groups validity was verified by dividing groups according to 'duration since diagnosis' (t = 2.65, p = .009), 'presence of sequela' (t = 10.16, p < .001), and 'awareness of distress' (t = 12.09, p < .001). The internal consistency of the scale using Cronbach's α for the total items was .93. Conclusion: The Ischemic Stroke Distress Scale is a valid and reliable tool that reflects stroke distress effectively. It is expected to be used as a basic tool to develop various intervention strategies to reduce distress in ischemic stroke patients.

• Journal of Korean Academy of Nursing
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• 제35권3호
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• pp.478-486
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• 2005

Purpose: The purpose of this study was to investigate the influencing factors on health-related quality of life of physically disabled persons. Method: Data was collected from 96 persons with a physical disability in three cities in Korea from June to September, 2003. Social support and depression were measured by a Social Support Questionnaire 6 ($SSQ_6$) and Center for Epidemiologic Studies Depression questionnaire (CES-D). The Rosenberg Self-esteem Scale was used to measure self-esteem. Health-related quality of life (HRQOL) was measured using Smith Kline Beecham Quality of Life Scale (SBQOL). The SPSS WIN 11.0 version program was used for data analysis. Result: There were significant differences of HRQOL according to monthly income and economic status. All subjects had a high level of depression and low self-esteem. Conclusion: The findings of this study show that self-esteem and the size of the social support network are significant influencing variables on HRQOL in physically disabled persons. Nursing intervention and counseling programs which improve self-esteem and increase the size of a social support network are needed to promote HRQOL in physically disabled persons.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.47-53
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• 2003

Objectives : I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea Methods : I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. Results : Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3); 1.05 (95% CI, 1.00- 1.09) for nitrogen dioxide (IQR=14.6ppb): 1.02 (95% CI,0.97-1.06) for sulfur dioxide (IQR=4.4ppb): 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb): and 1.03 (95% CI, 0.99-1.08) for carbon monoxide f10R=1.0ppm). Conclusions : This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution at levels below the current ambient air quality standards of Korea is harmful to sensitive subjects, such as asthmatic children.

• Journal of Environmental Health Sciences
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• 제40권4호
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• pp.265-278
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• 2014

Microbes such as bacteria, fungi, archaea, protists, and viruses are ubiquitous and people are exposed to them continuously. Endotoxin is a component of the outer membrane of Gram-negative bacteria and a potent proinflammaotry substance. When a person is exposed to environmental endotoxin, an innate immune response is initiated upon the initial recognition and this response produces various inflammatory mediators and recruits inflammatory cells to the exposed tissues. A purified chemical form of endotoxin is called lipopolysaccharide (LPS), and the lipid A portion of the molecule is a biologically active moiety. Exposure to endotoxin may result in various complex health effects depending on time, route, and dose of exposure, as well as host susceptibility. Gene-environment interactions play important roles in health effects of endotoxin exposure, e.g. development or aggravation of asthma. To accurately assess exposure to endotoxin in environmental or epidemiologic studies, methods of sampling, extraction, and analysis must be carefully selected since the selected methods may substantially affect analytical results and there is no internationally-agreed standard method to date. The lack of a standardized method hampers the establishment of exposure-response relationships. While an internationally-agreed health-based exposure limit does not exist, the Dutch Expert Committee on Occupational Safety recently recommended $90EU/m^3$ as a health-based occupational exposure limit. The current article reviews various scientific issues on how we measure environmental endotoxin and the health effects of endotoxin exposure.

• Physical Therapy Korea
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• 제19권1호
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• pp.76-85
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• 2012

The purpose of this study was to identify the factors determining the participation restriction of chronic stroke patients based on international classification of functioning, disability, and health (ICF) model. Sixty-eight stroke patients participated. The participants were assessed participation restriction using the Korean version of London handicap scale (K-LHS), modified Barthel index (K-MBI) to measure activities of daily living, Berg balance scale (K-BBS) to assess balance, and the center for epidemiologic studies depression (K-CES-D) to gauge depression. Also, 3 minutes walking test (3MWT), gait velocity, asymmetric posture, and family support were assessed. A stepwise multiple regression analysis was used to explore the factors determining participation restriction. There were no significant different in the K-LHS and K-MBI results by gender (p>.05). Correlations between the K-LHS and K-MBI (r=-.656), K-BBS (r=-.543), K-CES-D (r=.266), 3MWT (r=-.363), gait velocity (r=.348), and family support (r=-.389) were significant (p<.05). Also, the K-MBI and family support were the factors that determined participation restriction (p<.05) and that 40.2% of the variation in the K-LHS can be explained. Therefore, it is suggested that evaluation and intervention of patient's activity level and extent of family support is necessary to reduce participation restriction of chronic stroke patients.

• Journal of Korean Public Health Nursing
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• 제29권2호
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• pp.165-176
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• 2015

Purpose: This study was conducted to examine the relationships of depression symptom, self-esteem, and stress with health-related quality of life(HRQOL) in patients with hypertension registered to a community health center. Methods: This study was a correlational survey using a convenience sampling. A total of 110 patients diagnosed with hypertension were recruited from a health center in Gyeonggi-do. The questionnaires used were the Cardiovascular Disease Specific-HRQOL questionnaire, Center for Epidemiologic Studies Depression, Rosenberg Self-Esteem Scale, and Perceived Stress Scale. The acquired data were analyzed using IBM SPSS version 22.0. Multiple linear regression analysis was performed. Results: Moderate depression symptom(${\beta}=-.368$, p<.001), severe depression symptom (${\beta}=-.450$, p<.001), stress(${\beta}=-.339$, p=.001), and gender(${\beta}=-.148$, p=.049) were significant predictors for the HRQOL. Multiple linear regression showed that 51.8% ($R^2=.518$) of the variance in the HRQOL was explained. Conclusion: Based on these results, development of an intervention or education program, to decrease depression symptoms and stress is recommended. This may improve the HRQOL in patients with hypertension registered to a community health center.