• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.305-312
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• 2002

Objectives : The reproductive history of women has been suggested to have a possible influence on the risk of osteoporotic fractures. The purpose of this study was to assess the association between reproductive history and hip fractures in the elderly women. Methods : The study subjects were drawn from women members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, whose reproductive histories were available, and who were beneficiaries of the Korea Medical Insurance Corporation (KMIC) in 1993 and lived in Busan city, Korea. The information on reproductive histories, and possible confounders, were collected from mailed questionnaires. Potential hip fracture cases were collected from the claims data obtained between 1993 and 1998, with a hospital survey conducted to confirm the final diagnoses. Rate ratios and their 95% confidence intervals, were calculated using a Cox's proportional hazard model. Results : Following up 5,215 women for 6 years, 51 cases were confirmed with hip fractures. When adjusted for age, weight and physical activity, the rate ratio of hip fractures in women who had given birth three or more times was 0.56 (95% CI: 0.25-1.25), compared with those who had given birth two or less times. When adjusted for age, number of births, weight and physical activity, the rate ratio in women who first gave birth when younger than 22 years was 0.60 (95% CI: 0.34-1.08) compared with those who had giving birth at 22 years or older. Conclusions : According to these findings, an early age when first giving birth might decrease the risk of hip fractures in elderly Korean women.

• Communications for Statistical Applications and Methods
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• 제8권3호
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• pp.815-822
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• 2001

The aim of this study is to estimate the seroconversion date of the human immunodeficiency virus(HIV) infection for the HIV infected patients in Korea. Data are collected from two cohorts. The first cohort is a group of "seroprevalent" patients who were seropositive and AIDS-free at entry. The other is a group of "seroincident" patients who were initially seronegative but later converted to HIV antibody-positive. The seroconversion dates of the seroincident cohort are available while those of the seroprevalent cohort are not. Estimation of seroconversion date is important because it can be used to calculate the incubation period of AIDS which is defined as the elapsed time between the HIV infection and the development of AIDS. In this paper, a Weibull regression model Is fitted for the seroincident cohort using information about the elapsed time since seroconversion and the CD4$^{+}$ cell count.The seroconversion dates for the seroprevalent cohort are imputed on the basis of the marker of maturity of HIV infection percent of CD4$^{+}$cell count.unt.

• 한국노년학
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• 제29권4호
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• pp.1413-1425
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• 2009

본 연구는 서울 및 춘천지역 거주 중·고령자를 대상으로 부양책임감이 나이와 세대에 따라 어떻게 변화하고 있는지 분석하였다. 본 연구는 4차에 걸쳐 진행된 한림고령자패널 자료를 대상으로 램덤상수모델을 통해 세대 효과와 연령효과를 분석하였다. 본 연구에서는 실바흐(Sealbach)가 개발한 부양책임감 척도를 사용하였으며, 출생연도 1940년을 기준으로 이전 세대는 식민지·전쟁경험세대로, 이후세대는 산업화 민주화 세대로 구분하였다. 분석결과는 다음과 같다. 첫째, 식민지·전쟁경험세대는 산업화·민주화 세대에 비해 부양책임감이 높은 것으로 나타났다. 둘째, 연령효과를 살펴보면 일반적인 예상과는 달리 나이와 부양책임감 사이에는 통계적으로 유의미한 결과를 보이지 않는다. 서구의 연구는 노인부양의 어려움에 대한 인식이나 타인을 부양해야 한다는 의무감의 종료 등으로 인해 나아가 많은 노인일수록 부양책임감이 감소한다는 연구 결과를 제시하고 있는데, 이러한 측면이 우리나라에서는 적용되지 않는 것으로 보인다. 첫째와 둘째 결과에 비추어 볼 때 노인층이 장년층에 비해 부양책임감이 높은 것은 연령효과라기 보다는 세대효과일 가능성이 크다. 셋째, 남성이 여성에 비해, 서울이 춘천에 비해, 면지역 거주자가 동지역 거주자에 비해 부양책임감이 높은 것으로 나타났고, 주관적 건강 상태가 좋을수록, 학력 및 소득이 높을수록 부양책임감은 낮아지는 것으로 나타나고 있다.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.271-281
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• 2013

Objectives: Emerging evidence indicates that sleep duration is associated with health outcomes. However, the relationship of sleep duration with long-term health is unclear. This study was designed to determine the relationship of sleep duration with mortality as a parameter for long-term health in a large prospective cohort study in Korea. Methods: The study population included 13 164 participants aged over 20 years from the Korean Multi-center Cancer Cohort study. Information on sleep duration was obtained through a structured questionnaire interview. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using a Cox regression model. The non-linear relationship between sleep duration and mortality was examined non-parametrically using restricted cubic splines. Results: The HRs for all-cause mortality showed a U-shape, with the lowest point at sleep duration of 7 to 8 hours. There was an increased risk of death among persons with sleep duration of ${\leq}5$ hours (HR, 1.21; 95% CI, 1.03 to 1.41) and of ${\geq}10$ hours (HR, 1.36; 95% CI, 1.07 to 1.72). In stratified analysis, this relationship of HR was seen in women and in participants aged ${\geq}60$ years. Risk of cardiovascular disease-specific mortality was associated with a sleep duration of ${\leq}5$ hours (HR, 1.40; 95% CI, 1.02 to 1.93). Risk of death from respiratory disease was associated with sleep duration at both extremes (${\leq}5$ and ${\geq}10$ hours). Conclusions: Sleep durations of 7 to 8 hours may be recommended to the public for a general healthy lifestyle in Korea.

• Clinical and Experimental Pediatrics
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• 제55권8호
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• pp.259-264
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• 2012

Wheezing is one of the most frequent complaints that lead to the use of medical resources in younger children. Generally, wheezing is caused by bronchiolitis and resolves spontaneously without recurrence, but sometimes, wheezing can progress into asthma. Early data on the natural history of childhood wheezing was mostly obtained from retrospective reviews of medical records or from questionnaires, which made it difficult to exclude biases. Now that many cohort studies are available, reviewing the results of birth cohort studies makes it possible to understand the natural course of early childhood wheezing and the risk factors for asthma. In this study, we have reviewed the various phenotypes of early childhood wheezing and their natural courses to help select the most appropriate management modalities for the different types of early childhood wheezing.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.65-74
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• 2024

Purpose: This longitudinal cohort study aimed to evaluate the relationship between osteonecrosis of the jaw and pulp and periapical disease in patients who were administered bisphosphonates. Methods: Using data from a nationwide cohort, we examined the association among dental caries, pulp and periapical disease, and osteonecrosis of the jaw in women aged >50 years who received bisphosphonates for more than 1 year between 2002 and 2015. Because of ambiguities in the diagnosis of osteonecrosis of the jaw in population-based data, we operationally defined and categorized the condition into established and potential osteonecrosis of the jaw. Results: Pulp and periapical disease significantly increased the development of both established and potential osteonecrosis of the jaw (hazard ratio, 2.21; 95% confidence interval, 1.40-3.48; and hazard ratio, 2.22; 95% confidence interval, 1.65-2.98, respectively). Root canal treatment did not have any influence on the development of osteonecrosis of the jaw. Conclusions: Pulp and periapical disease may be a major risk factor for osteonecrosis of the jaw. The study findings suggest that patients should undergo regular dental examinations to detect pulp and periapical disease before or during the administration of bisphosphonates and that root canal treatment should be considered to decrease the risk of osteonecrosis of the jaw.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2005년도 제57차 추계 학술대회 연제집
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• pp.363-364
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• 2005

• Journal of Preventive Medicine and Public Health
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• 제35권1호
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• pp.41-48
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• 2002

Objectives : To review the drug prescription pattern of antiulcerative agents for elderly inpatients, Methods : The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1594. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription, Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. Results : The number of patients prescribed antiulcerative agents was 1,059 (64,9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by $H_2$ antagonist (16.0%), Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the fetal omeprazole prescriptions. Conclusions : Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulceratiye agents.

• Journal of Preventive Medicine and Public Health
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• 제47권1호
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• pp.36-46
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• 2014

Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history. Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ${\geq}65$ years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ${\leq}50{\mu}g/d$, 51 to $100{\mu}g/d$, 101 to $150{\mu}g/d$, and > $150{\mu}g/d$. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status. Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to $100{\mu}g/d$ group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to 100 ${\mu}g/d$ group, was 1.93 (95% CI, 1.14 to 3.26). Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2005년도 제57차 추계 학술대회 연제집
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• pp.451-451
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• 2005