• Genomics & Informatics
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• v.8 no.4
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• pp.206-211
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• 2010

The Fas (TNF receptor superfamily, member 6) (FAS)/FAS ligand (FASLG) interaction plays a central role in the regulation of programmed cell death. FAS and FASLG polymorphisms in promoter regions affect transcriptional activities. To investigate whether FAS and FASLG polymorphisms are associated with the development and clinical phenotypes of stroke, 2 promoter single nucleotide polymorphisms (SNPs) in FAS (rs1800682, -670C/T) and FASLG (rs763110, -844C/T) were selected and genotyped by direct sequencing in 220 stroke patients [107 ischemic stroke (IS), 77 intracerebral hemorrhage (ICH), and 36 subarachnoid hemorrhage (SAH)] and 369 control subjects. For the analysis of clinical symptoms, all stroke patients were divided into 3 clinical phenotypes according to the respective results of the National Institutes of Health Stroke Survey (NIHSS) and the Modified Barthel Index (MBI) and the presence or absence of complex regional pain syndrome (CRPS). The SNPStats, SNPAnalyzer, and Helixtree programs were used to analyze the genetic data. Multiple logistic regression models (codominant, dominant, and recessive) were used to estimate odds ratios (ORs), 95% confidence intervals (CIs), and p-values. The promoter SNP rs1800682 was associated with stroke in the codominant (OR=0.48, 95% CI=0.25-0.94, p=0.04) and dominant models (OR=0.51, 95% CI=0.30-0.87, p=0.011). However, a FASLG SNP (rs763110) was not in Hardy-Weinberg equilibrium (p<0.05). In the analysis of stroke types, rs1800682 was associated with IS in the codominant (OR=0.30, 95% CI=0.12-0.74, p=0.025), dominant (OR=0.44, 95% CI=0.23-0.88, p=0.018), and recessive models (OR=0.45, 95% CI=0.21-0.99, p=0.042). The genotype frequencies of rs1800682 were different between ICH and controls in the dominant model (OR=0.49, 95% CI=0.26-0.94, p=0.031) but not between SAH and controls. In the analysis of clinical symptoms, however, rs1800682 was not related to the 3 clinical phenotypes (NIHSS, MBI, and CRPS). These results suggest that a promoter SNP (rs1800682, -670C/T) in FAS may be associated with the development of stroke in the Korean population.

• Child Health Nursing Research
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• v.20 no.3
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• pp.215-224
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• 2014

Purpose: This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. Methods: A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. Results: Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. Conclusion: The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.

• Tuberculosis and Respiratory Diseases
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• v.80 no.1
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• pp.45-51
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• 2017

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic method for mediastinal and hilar lymphadenopathy. This study aimed to investigate the incidence of fever following EBUS-TBNA. Methods: A total of 684 patients who underwent EBUS-TBNA from May 2010 to July 2012 at Seoul National University Hospital were retrospectively reviewed. The patients were evaluated for fever by a physician every 6-8 hours during the first 24 hours following EBUS-TBNA. Fever was defined as an increase in axillary body temperature over $37.8^{\circ}C$. Results: Fever after EBUS-TBNA developed in 110 of 552 patients (20%). The median onset time and duration of fever was 7 hours (range, 0.5-32 hours) after EBUS-TBNA and 7 hours (range, 1-52 hours), respectively, and the median peak body temperature was $38.3^{\circ}C$ (range, $137.8-39.9^{\circ}C$). In most patients, fever subsided within 24 hours; however, six cases (1.1%) developed fever lasting longer than 24 hours. Infectious complications developed in three cases (0.54%) (pneumonia, 2; mediastinal abscess, 1), and all three patients had diabetes mellitus. The number or location of sampled lymph nodes and necrosis of lymph node were not associated with fever after EBUS-TBNA. Multiple logistic regression analysis did not reveal any risk factors for developing fever after EBUS-TBNA. Conclusion: Fever is relatively common after EBUS-TBNA, but is transient in most patients. However, clinicians should be aware of the possibility of infectious complications among patients with diabetes mellitus.

• Health Policy and Management
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• v.27 no.1
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• pp.39-46
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• 2017

Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.4
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• pp.237-242
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• 2015

The coagulation factor activity compared two groups of the lower 10% (29.1~30.9 sec) and the upper 10% (38.0~41.9 sec) of the normal reference range of aPTT. The aim of this study was to investigate the influence of sex, age, and ABO blood type on coagulation factor activity. There was significant difference in the activity of the coagulation factor assay based on age. The VIII (p<0.0001) and IX (p=0.0050) in the lower group of samples from those over sixty years of age is higher than from those under sixty. In contrast, XII (p=0.0285) for samples over sixty was lower than for samples under sixty. While in the upper group V (p=0.0219), VIII (p=0.0005), and IX (p=0.0014) for samples from the over sixty group was higher than those under sixty. In the case of activity of coagulation factor between O and non-O blood type, VIII (p<0.001) activity of the non-O blood type was higher than that of the O blood type in the both groups. The XII (p=0.016) activity of non-O blood type was lower than that of O blood type in the upper group. According to the multiple logistic regression analysis, when other variables are under the same conditions between lower and upper groups, there is a strong possibility for the lower group when activity of V (p=0.001), VIII (p<0.001), X (p<0.001) and XII (p<0.001) is increased. Furthermore, there is also a strong possibility of upper group when activity of II (p=0.004) and IX (p=0.012) is increased. However, no significant difference in between sex, age and XI was observed.

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.479-489
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• 2017

The purpose of this study was to identify factors associated with falls among older adults. This cross-sectional study used the data of 10,272 older adults who participating in the Korean Elderly survey, including demographic and health related characteristics. The data were analyzed with complex samples in SPSS ver. 23.0. The results of multiple logistic regression analysis showed that age (OR=1.262, 95%CI 1.111-1.433), education (OR=0.846, 95%CI 0.764-0.937), subjective health status (OR=1.172, 95% CI 1.041-1.320; OR=1.422, 95%CI 1.289-1.570), number of chronic illness (OR=1.438, 95%CI 1.050-1.968), number of medications (OR=0.798, 95%CI 0.659-0.967), muscle strength of low extremities (OR=1.260, 95%CI 1.101-1.441), and fear of falling (OR=3.576, 95%CI 3.166-4.039; OR=14.236, 95%CI 12.637-16.038)were significantly associated with fall accidents in the elderly. Thus, it is necessary to develop fall prevention program to reduce fear of falling and improve health status in the elderly.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.166-173
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• 2004

Objectives : Cervical cancer is the second most frequent cancer among women in Busan. The Pap smear test could have a significant effect on detecting cervical cancer, and enhancing their rate of use is an important strategy for reducing the incidence and mortality of cervical cancer. This study aimed to evaluate the factors associated with the past use of the Pap smear test in Korean women. Methods : A population-based survey was carried out in Busan between November 1999 and March 2000. 1,673 participants were randomly selected from 2,684 women in Busan, using a 2-stage cluster sampling method, and interviewed in their homes. Their socio-demographic characteristics, smoking, drinking, familial cancer history, Pap smear screening history, reproductive and menstrual factors, sexual habits and use of contraceptive methods data were collected by a trained interviewer using a questionnaire. The use of the screening test was defined by a self-report from the participants on how many times they had had a Pap smear test in their lifetime, and when they had received their latest examination. Results : Of the 1,673 respondents (62.3% response rate), 57.6% had had a Pap smear test during her life (mean number, 2.3). Among the health examination participants(1,064), 961(90.3%) reported having sexual experience and 70.9% of these had had a Pap smear test. In a multiple logistic regression analysis, statistically significant relationships were observed for age groups and the Pap smear test rate (odds ratio, OR for 35-44 years=2.45; OR for 45-54 years=3.41; OR for 55 years=2.60; reference, under 34 years). The married or cohabiting women were more likely to have used the Pap smear test than those separated or widowed (OR=1.73). Among the reproductive behavioral measures, the number of births (OR for 3 births=4.22; OR for 2 births=3.95; OR for 1 births=3.38; reference, 0 births) and husband's extra-marital affairs (OR=1.50) were associated with the rates of use of Pap smear tests. Conclusion : It appears that the most important contributing factors to cervical cancer screening were age, marital status and number of births. A positive association was also observed for the husband's extra-marital affairs. This study enabled us to systematically assess the relationship between Pap smear rates and risk factors for cervical cancer. It is hoped that this study will make a significant contribution to the accumulating scientific evidence on the identification of factors associated with cervical cancer screening in Korea.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.346-352
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• 2013

Objectives: To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study. Methods: The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer. Results: Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer. Conclusions: Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.471-480
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• 1998

This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.

• Journal of the Korean Society of School Health
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• v.14 no.1
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• pp.115-130
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• 2001

Dieting behaviors prevail among most women and are highly increasing among female adolescents who don't have to lose weight. The dieting behaviors of normal or low weight groups are highly related to the negative impact of health risk behaviors. We need a strategy for intervening in the dieting behaviors of relevant groups. With this background, a study was conducted to examine the current situation of dieting behaviors and related factors in middle school girls, and to provide guidelines for the relevant dieting group. This survey was carried out by self-questionnaires passed out to 901 middle school girls from 3 middle schools in Seoul. Data were collected from April 10th, 2000 to April 17th, 2000 and 794 respondents' data were finally selected for analysis. The instruments of this study were Shin's scale for effects of mass-media, Birleson's depression self-rating scale translated by shim, Rosenberg's self-esteem scale, Smilkstein's Family APGAR score translated by Yoon, Kim's school-related adjustment scale. The credibility of instruments was 0.41~0.83 in the pilot study and 0.70~0.86 in the main study. The summary of results was as follows: 1. The general characteristics of respondents were analyzed. In comparison of grade and dieting behaviors, the subjects of the group perceived that their body image was obeser than their real body image and their ideal body image was slenderer than their current body image. A dieter's body image was seriously distorted. 2. The dieting behaviors were analyzed. The Subjects' BMI was within the normal to low range -- they didn't have to lose weight. But actually 47.3% of the respondents were dieters. Their main dieting methods were exercise(71.8%), computer games(64.9%) such as DDR and pump, and intake reduction(64.1%). Most dieters were using desirable methods such as exercise and intake control. But unhealthy methods such as saunax, smoking and harmful drug-use were also used by a few dieters. The main reason for dieting was attractiveness. The chief resources of dieting methods were mass-media(67.8%), friends(64.3%), and parents & relatives(35.1%). Only a few subjects obtained the information from health professionals. While they were trying to lose weight, 42.1% of the subjects experienced side effects such as dizziness(45.0%), apathy(20.5%), appetite loss(18.5%), amenorrhea and the irregularity of the menstrual cycle(16.6%). 3. The relationship between dieting behaviors and factors was analyzed. Dieting behaviors were significantly related to the experience of menarche, the experience of dating with heterosexuals, perceived body image, self-esteem, depression, family's relationship, school instruction-related adjustment, school life-related adjustment, and the effect of mass-media. After that, the multiple logistic regression was used. The analysis revealed that dating, perceived body image, the experience of menarche and the effect of mass media were significant factors. In conclusion, strategies for preventing irrelevant dieting behaviors are urgently required to enhance female adolescents' ability to choose the right information from countless others and to recognize their optimum body image.