• Journal of Acupuncture Research
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• v.15 no.2
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• pp.493-509
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• 1998

Osteoarthritis(degenerative joint disease), the most common arthropathy affecting the aged people, is characterized by degeneration of articular cartilage with proliferation and remodeling of subchondral bone. Osteoarthritis of the knee, which probably has greater social cost and more associated disability than osteoarthritis of any other joint, prevalence is known to increase with age, and females have higher rates than males; radiographic abnormalities are present in more than 30% of persons more than 65 years old, with approximately 40% of these persons symptomatic. Though the etiology of osteoarthritis is not entirely understood, much information is available regarding risk factors for the development of knee osteoarthritis that permit some reasonable guideline for preventive strategies. Traumatic damage or occupational or recreational overuse of knee joint may result in osteoarthritis, and obesity also is related to osteoarthritis of the knee. A variety of other possible risk factors for the development of knee osteoarthritis have been proposed, including increased bone mass, smoking, diseases such as diabetes or elevated serum uric acid, and some metabolic factors, but the contribustions of these and other factors such as smoking or race and diseases such as diabetes are as yet undetermined. The usual clinical manifestations include pain, stiffnesss, crepitus and loss of function. In oriental medicine, osteoarthritis of the knee is very similar to diseases such as Bijung(痺症), Haksulpung(鶴膝風), Youkjeolpung(歷節風) in symptoms. The diseases such as Bijung(痺症), Haksuipung(鶴膝風), Youkjeolpung(歷節風) is related to the of function liver(肝) and kidney(腎) and risk factors are regarded as Pung(風), Han(寒), sub(濕). The diagnosis of osteoarthritis of the knee has often been based on radiographic appearance and clinical manifestations. The acupuncture therapy of osteoarthritis of the knee has often been based on Stomach meridian(ST), Spleen meridian(SP), Kidney meridian(KI), Liver meridian(LR).

• The Korean Journal of Health Service Management
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• v.11 no.2
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• pp.81-91
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• 2017

Objectives : The purpose of this study was to provide basic data for the development of general and oral health improvement programs for the elderly by analyzing the effect of health risk factors on the remaining teeth of the elderly in day care centers. Methods : The subjects were 294 elderly people who used day care centers in Seoul. Results : In terms of health risk factors, the elderly who did not have diabetes or smoke had more remaining teeth. In terms of oral health risk factors, the elderly with no dental caries, periodontal disease and dental pain had more remaining teeth. Conclusions : It is necessary to activate systematic welfare services for the elderly that fit their lifestyle in the light of the health and oral health risk factors of the elderly who use day care centers.

• The Journal of Korean Medicine
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• v.24 no.4
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• pp.19-24
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• 2003

Background and Purposes : Smoking is a well-known risk factor for ischemic stroke. It may contribute to s1Toke by inducing the aggregation of platelets and formation of atheroma, reducing cerebral blood flow, and increasing fibrinogen. However, the relative risk varies according to different ethnicity and area. Therefore, we performed this study to assess the risk of smoking for ischemic s1Toke in Korea. Methods : Cigarette smoking habit was studied in 308 patients with ischemic s1Toke and in 348 age- and sex-matched control subjects who had no history of stroke using case control methods. In multiple logistic regression analysis, smoking had a significant value of odds ratio adjusted for hypertension, diabetes mellitus, and hyperlipidemia. Results : The adjusted odds ratio (AOR) and 95％ confidence interval (CI) was significant in the medium smokers (AOR, 1.92; 95％ CI, 1.11 to 3.33: p< 0.05) and heavy smokers (AOR, 2.80; 95％ CI, 1.64 to 4.78: p< 0.05). Furthermore, the OR was higher in hypertensive subjects than in normotensive subjects compared to non-smokers (AOR, 1.98; 95％ CI, 1.01 to 3.85: p< 0.05). Conclusions : Our findings suggest that smoking is an independent risk factor for ischemic stroke in Korea.

• Journal of Korean Biological Nursing Science
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• v.19 no.3
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• pp.131-140
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• 2017

Purpose: Dyslipidemia was a known risk factor for cardiovascular disease and was a leading cause of mortality in worldwide. This study aimed to determine the factors associated with prevalence and medication treatment of dyslipidemia in Korean adult population. Methods: In this study, based on the criteria set by the Korean Society of Lipidology and Atherosclerosis, the factors associated with prevalence and medication treatment of dyslipidemia was evaluated in a population of 12,506 people ($age{\geq}20$), who participated in the Korean National Health and Nutrition Examination Survey (2013-2015). The findings were tested by using multivariate logistic regression. Results: Dyslipidemia prevalence rate was 36.5%. Among populations with dyslipidemia, 17.5% were treated with lipid-lowering drugs. In the multivariate logistic regression model, male, increase in age, lower education level, non-drinker, current smoking, less physical activity, increase of body mass index, hypertension, and diabetes were associated with an increased odd of dyslipidemia. Female, increase in age, higher income, excess fat intake, hypertension, diabetes, myocardial infarction, and angina were associated with an increased odd of medication treat. Conclusion: The results of this study could be used to screen patients at the high risk for dyslipidemia or to predict medication adherence.

• The Korean Journal of Food And Nutrition
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• v.29 no.3
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• pp.392-403
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• 2016

The purpose of this study was to investigate the relations between HbA1c level and health risk factor. For analysis, 330 elderly women aged 65 years and over were recruited in Jeonla province, Korea. The subjects were classified into two groups according to their HbA1c level; the diabetic group (HbA1c level${\geq}6.5%$, n=68, 20.6%) and control group (HbA1c level<6.5%, n=262, 79.4%). Demographic characteristics were collected, as well as information on physical measurements, blood tests for biochemical indicators, a health status and health-related life style, dietary behavior, favorite food groups, consumption frequency of food groups and nutrient intake. Educational level of the diabetic group was significantly lower than that of the control group. The height of the diabetic group was shorter, and percentage fat of the diabetic group was higher than those of the control group. In the diabetic group, the higher concentrations of creatinine and activity of alkaline phosphatase were found to be significantly unfavorable factors. Therefore, the diabetic group was assumed to be at risk of decreased liver and renal function. The self-rated health level of the diabetic group has a declining tendency, while the medicine intake was significantly higher than that of the control group, but there are no significant differences in visiting frequency of hospital and community health center. The distribution of physical activity showed a significant difference between the groups. Although there are no significant differences in nutrient intake, the diabetic group had relatively inferior nutrient intake of diet, especially vitamin C, as contrasted with the control group. In conclusion, the weight control and increasing physical activity may be effective in the prevention of the diabetes and continuous education and intervention by specialized nutritionists will be needed for diabetic patients. These results could be useful to plan effective strategies to increase the health-life expectancy and the prevention of the diabetes of Korean elderly people living in rural areas.

• Clinics in Shoulder and Elbow
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• v.22 no.3
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• pp.128-134
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• 2019

Background: Patients with rotator cuff tears are usually afflicted with shoulder pain and disability. However, it is unclear which factors are related to shoulder pain in patients with rotator cuff tears. This study was therefore undertaken to determine the factors correlated with shoulder pain in patients with painful rotator cuff tears, but without any history of trauma. Methods: We evaluated a cohort of 745 patients with painful rotator cuff tears having no trauma history, and analyzed the relationship between pain and multiple factors including demographic data, tear characteristics, and passive range of motion. Pain was analyzed with a questionnaire concerning the visual analogue scale (VAS) for pain. Tear characteristics were determined by evaluating tear size, muscle atrophy, number of torn tendons, and presence of arthritis. Multivariate linear regression analysis and chi-squared test were applied to evaluate the relationship between the VAS for pain and variable factors. Results: Shoulder pain was associated with young age (p=0.01), male sex (p=0.01) and the presence of diabetes mellitus (p<0.001). Measurements of rotator cuff tear characteristics including tear size (p=0.53), muscle atrophy (p=0.16) and the number of torn tendons (p=0.34) did not correlate with shoulder pain. Symptom duration (p=0.60) and range of motion (p>0.05) also showed no correlation with VAS for pain. Conclusions: Young age, male sex and the presence of diabetes mellitus correlated positively with preoperative shoulder pain in patients with painful rotator cuff tears without a trauma history. Combined treatment of pain management and risk factor correction could be helpful to control preoperative shoulder pain.

• Korean Journal of Health Education and Promotion
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• v.20 no.2
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• pp.113-125
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• 2003

Background： Recently, adolescent obesity was increased and tended to become obese adults, facing increased risk for diabetes, cardiovascular disease. Even before reaching adulthood, adolescent obesity already was experiencing hypertension, dyslipidemia, and diabetes mellitus. The purpose of this study was to find prevalence of obesity of high school students in Jeju island and association between obesity and cardiovascular risk factors and association between childhood obesity and adolescent obesity. Method： The study subjects were 6,064 students of twenty-two high school in Jeju island and health survey data was gathered from high school health examination data and hospital health examination data from Aug. 1999 to Dec. 1999. Adolescent obesity was evaluated by ideal body weight method in 1998 and body mass index. Cardiovascular risk factors were checked total cholesterol, systolic and diastolic blood pressure, fasting blood sugar. In 1,534 students, obesity at primary school is checked by primary and middle school health record. Results： Prevalence of obesity in Jeju island high school students is 12.6% in male students, 13.3% in female students by ideal body weight method and 8.7% in male students, 8.5% in female students by body mass index. Prevalence of obesity of male students in city area and district area of Jeju island were each 12.9%, 10.3% and that of male students in city area was significantly higher. Prevalence of obesity of female students in city area and district area of Jeju island were each 12.9%, 14.2% and not significantly different. Prevalence of obesity of male students in general and commercial school group were each 13.9%, 10.1% and that of general school group was significantly higher. In female students, Prevalence of obesity general and commercial school group was not significantly different. Total cholesterol, systolic and diastolic blood pressure were significantly associated with degree of obesity in male and female students(p＜0.05) and fasting blood sugar was only significantly associated with degree of obesity in male students(p＜0.05). In 1,514 students checked by health record, Odds ratio of obesity at primary and middle school that at high school were 12.96∼22.77 and was significantly associated. Conclusion： Prevalence of obesity of high school students in Jeju island is very high and adolescent obesity was significantly associated with cardiovascular risk factors. Mostly childhood obesity tended to become adolescent obesity and program of control of obesity at childhood and adolescence is required.

• Investigative Magnetic Resonance Imaging
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• v.22 no.3
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• pp.150-157
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• 2018

Purpose: To assess associations between morphological characteristics of intracranial arteries in time-of-flight MR angiography (TOF-MRA) and atherosclerotic risk factors. Materials and Methods: From January 2014 to October 2015, a total of 129 patients (65 men and 64 women) without intracranial arterial stenosis > 50% were included in this study. All MRIs were performed using a 3T machine with 3D TOF-MRA sequences. We evaluated irregularity, tortuosity, and dilatation of intracranial arteries in maximal intensity projection (MIP) of TOF-MRA. Subjects' risk factors for atherosclerosis including history of hypertension and diabetes were collected by reviewing their medical records. Associations between morphological characteristics and each known atherosclerosis risk factor were examined using univariate regression analysis. Multivariate regression models were built to determine combined association between those risk factors and morphologic changes of intracranial arteries. Results: In multivariate analysis, hypertension (coefficient [95% CI]: 0.162 [0.036, 0.289], P = 0.012) and absence of diabetes (coefficient [95% CI]: -0.159 [-0.296, -0.023], P = 0.022) were associated with large diameter of intracranial arteries. Males (coefficient [95% CI]: 0.11 [-0.006, 0.23], P = 0.062) and higher age (coefficient [95% CI]: 0.003 [-0.001, 0.008], P = 0.138) had marginal association with increased diameter. Tortuosity was associated with old age (OR: 1.04 [1.02, 1.07], P < 0.001). Irregular contour of intracranial arteries was significantly associated with old age (OR: 1.05 [1.02, 1.09], P = 0.004), presence of diabetes (OR: 2.88 [1.36, 6.15], P = 0.0058), and previous ischemic stroke (OR: 3.91 [1.41, 11.16], P = 0.0092). Conclusion: Morphological characteristics (irregularity, tortuosity, dilatation) of intracranial arteries seen in TOF-MRA might be associated with atherosclerotic risk factors in subjects with no or mild stenosis.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.132-140
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• 2005

Objectives: To propose a risk-adjustment model from insurance claims data, and analyze the changes in cesarean section rates of healthcare organizations after adjusting for risk distribution. Methods: The study sample included delivery claims data from January to September, 2003. A risk-adjustment model was built using the 1st quarter data, and the 2nd and 3rd quarter data were used for a validation test. Patients' risk factors were adjusted using a logistic regression analysis. The c-statistic and Hosmer-Lemeshow test were used to evaluate the performance of the risk-adjustment model. Crude, predicted and risk-adjusted rates were calculated, and compared to analyze the effects of the adjustment. Results: Nine risk factors (malpresentation, eclampsia, malignancy, multiple pregnancies, problems in the placenta, previous Cesarean section, older mothers, bleeding and diabetes) were included in the final risk-adjustment model, and were found to have statistically significant effects on the mode of delivery. The c-statistic (0.78) and Hosmer-Lemeshow test ($x^2$=0.60, p=0.439) indicated a good model performance. After applying the 2nd and 3rd quarter data to the model, there were no differences in the c-statistic and Hosmer-Lemeshow $x^2$. Also, risk factor adjustment led to changes in the ranking of hospital Cesarean section rates, especially in tertiary and general hospitals. Conclusion: This study showed a model performance, using medical record abstracted data, was comparable to the results of previous studies. Insurance claims data can be used for identifying areas where risk factors should be adjusted. The changes in the ranking of hospital Cesarean section rates implied that crude rates can mislead people and therefore, the risk should be adjusted before the rates are released to the public. The proposed risk-adjustment model can be applied for the fair comparisons of the rates between hospitals.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3931-3936
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• 2015

Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.