• Journal of Preventive Medicine and Public Health
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• 제51권1호
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• pp.33-40
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• 2018

Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The $Besag-York-Molli{\acute{e}}$ (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in at-risk areas.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.36-45
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• 2008

Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

• 한국환경보건학회지
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• 제39권4호
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• pp.335-345
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• 2013

Objectives: As the suspicion was raised that 'Agent Orange' was reclaimed 30 years ago at Camp Carol, located in Waegwan, Gyeongsangbuk-do, the government conducted an investigation of the influence of environmental and health effects around Camp Carol through a public-private joint investigation team. As part of the investigation of population health effects, this study was carried out in order to observe changes and regional differences in diseases, particularly cancer, by year. Methods: We authors conducted an analysis of secondary health data, such as cancer registration data, mortality data, and health insurance data. We drew an age standardized incidence ratio (SIR), death rate (SDR), mortality ratio (SMR), and health care utilization rate using these data. Results: For gastric cancer in women, and other cancers in men, a significant increase in incidence was observed compared to the control area. For biliary tract cancer, gallbladder cancer, and thyroid cancer in women, and prostate cancer in men, a significant decrease in incidence was observed compared to the control area. In the national statistical analysis of data, such as health insurance data and mortality data, we did not observe a significant increase at the Waegwan region compared to other regions. Conclusions: We must consider the limitations of this study. Because thirty years have passed from the time of the estimated landfill of 'Agent Orange', recent national statistical data may not reflect the past real situation. Therefore, the monitoring of secondary data for health effects at the municipal level should be carried out continuously.

• Journal of Korean Medical Science
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• 제33권47호
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• pp.292.1-292.10
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• 2018

Background: We investigated the incidence of active tuberculosis among patients with inflammatory bowel disease (IBD) treated with tumor necrosis factor (TNF) inhibitors, with or without latent tuberculosis infection (LTBI). Methods: The study was performed at a Korean tertiary referral center between January 2011 and June 2017. In total, 740 patients with IBD who underwent LTBI screening tests and were followed-up for ${\geq}1$ year after TNF inhibitor treatment initiation were enrolled. LTBI was detected on the basis of tuberculin skin test results, interferon-gamma release assay results, chest X-ray findings, and previous tuberculosis treatment history. The patients were classified into LTBI (n = 84) or non-LTBI (n = 656) group. The risk of developing tuberculosis in each group was assessed on the basis of standardized incidence ratio (SIR) and 95% confidence interval (CI) for active tuberculosis. Results: Mean patient age was 33.1 years, and patients with Crohn's disease were predominant (80.7%). Within 1 year after the initiation of TNF inhibitor treatment, 1 patient in the LTBI group (1/84; 1.2%) and 7 patients in the non-LTBI group (7/656; 1.1%) developed active tuberculosis. The overall 1-year incidence of tuberculosis among the patients was significantly higher than that among the general population (SIR, 14.0; 95% CI, 7.0-28.0), and SIR was not affected by LTBI status (LTBI group: 14.5, 95% CI, 2.0-102.6; non-LTBI group: 14.0, 95% CI, 6.7-29.4). Conclusion: Patients with IBD undergoing TNF inhibitor treatment showed a higher 1-year incidence of tuberculosis than the general population irrespective of LTBI status.

• Safety and Health at Work
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• 제8권2호
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• pp.169-174
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• 2017

Background: We assessed the cancer risks of four different Finnish asbestos-exposed cohorts. We also explored if the cohorts with varying profiles of asbestos exposure exhibited varying relative risks of cancer. Methods: The incident cancer cases for the asbestos-exposed worker cohorts were updated to the end of 2012 using the files of the Finnish Cancer Registry. The previously formed cohorts consisted of asbestos mine workers, asbestosis patients, asbestos sprayers, and workers who had taken part in a screening study based on asbestos exposure at work. Results: The standardized incidence ratio (SIR) for mesothelioma varied from about threefold to > 100-fold in the different cohorts. In the screening cohort the SIR for mesothelioma was highest in 2003-2007, In other cohorts it was more constant in 5-year period inspection. The SIR for lung cancer was about twofold to tenfold in all except the screening cohort. Asbestos sprayers were at the highest risk of mesothelioma and lung cancer. Conclusion: The SIR for mesothelioma is high in all of the cohorts that represent different kinds of asbestos exposure. The smaller SIR for mesothelioma in the screening cohort with lowest level of asbestos exposure might suggest dose-responsiveness between asbestos exposure and mesothelioma. It does seem that the highest risk of lung cancer in these cohorts except in the youngest of the cohorts, the screening cohort, is over. The highest SIR for lung cancer of the asbestosis patient and sprayers cohort is explained by their heavy asbestos exposure.

• 대한상부위장관⦁헬리코박터학회지
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• 제18권3호
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• pp.215-216
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• 2018

위암의 발병률이 감소하고 있기는 하지만 전 세계적으로 여전히 연 100만 명 이상이 새롭게 위암으로 진단되고 있으며, 앞으로 향후 몇십 년 동안은 인구의 고령화로 인하여 위암에 대한 사회적 경제적 부담이 줄어들지 않을 것으로 추측된다. 최근 메타분석에서 Helicobacter pylori 제균 치료가 위암발병을 33~47% 감소시킨다고 보고하였으나, 중국에서 시행된 무작위 대조 연구에서는 제균 치료가 위암의 전구 병변 감소에 도움이 되지 않았다고 보고하고 있어 위축성 위염이나 장상피화생을 동반한 경우 제균 치료가 위암 예방에 큰 도움이 되지 않을 수 있음을 제시하고 있다. 그렇다면 위축성 위염이 있는 경우가 많은 고령 환자에서는 과연 헬리코박터 제균 치료가 도움이 될 것인가? 저자들은 빅데이터 분석을 통해 헬리코박터 제균 치료가 위암 발병에 미치는 영향을 성별과 연령에 따라 분석하였다. 2003년부터 2012년까지 'Hospital Authority'에 등록된 clarithromycin 포함 3제 요법을 받은 환자들에서의 위암 발생률과 2003년부터 2013년까지 'Hong Kong Cancer Registry'에 등록된 성별과 연령이 일치된 대조군에서의 위암기대 발생률(expected incidence)을 비교하였다. 3제 요법을 받은 73,237명의 환자들을 확인하였을 때, 평균 7.6년의 추적기간 중 200명(0.27%)에서 위암이 발생하였다. 연령에 따라 40세 미만, 40~59세, 60세 이상의 그룹으로 나누어 각각 위암발생률을 대조군과 비교한 결과 60세 이상 환자군에서만 standardized incidence ratio (SIR)가 0.82로 감소하였다. 치료 성공여부에 따라 위암 발생률을 분석하였을 때, 제균 치료에 성공한 60세 이상 군에서 SIR이 0.78로 감소하였으나 재 치료를 받은 40~59세 군에서는 SIR이 2.43으로 증가하였다. 제균 치료시점이 위암 발생률에 미치는 영향으로는 제균 치료 후 10년 미만에서의 위암 발생률에는 큰 영향이 없었으나 10년 이상 경과한 경우 60세 이상 군과 40~59세 군에서의 위암 발병률이 대조군의 위암 예측 발병률보다 낮았다.

• 한국산업보건학회지
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• 제32권3호
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• pp.242-252
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• 2022

Objectives: Firefighters and police officers are exposed to various occupational hazards. No studies in Korea have investigated the occurrence of cancer by type of cancer for the two occupations. This study aims to investigate the risk of occurrences associated with types of cancers in firefighters and police officers. Methods: Utilizing National Health Insurance(NHI) Claims data from 2006-2015, the study included 8,871,468 general workers, 25,001 firefighters, and 102,274 police officers. Using general workers as a control group, we calculated the standardized incidence ratios(SIR) by types of cancer for firefighters and police officers. After calculating the SIR for all subjects, the SIR was calculated by stratifying according to gender. Results: SIR of colon cancer 1.38(95% CI, 1.11-1.69), cancer of the liver and intrahepatic bile ducts 1.27(95% CI, 1.04-1.54), and 1.88(95% CI, 1.28-2.65) bladder cancer were higher firefighters than general workers. SIR of Lip, oral cavity, and pharynx 1.26(95% CI, 1.07-1.47), Stomach 1.14(95% CI, 1.06-1.23), colon 1.33(95% CI, 1.21-1.46), liver and intrahepatic bile ducts 1.21(95% CI, 1.10-1.32), pancreas 1.24(95% CI, 1.02-1.49), other skin 1.60(95% CI, 1.26-2.00), bladder 1.27(95% CI, 1.04-1.54), other urinary tract 1.46(95% CI, 1.27-1.68), other parts of central nervous system 1.68(95% CI, 1.10-2.46) were higher police officers than general workers. Conclusions: Both firefighters and police officers are exposed to various cancer occurrence risks, necessitating the development of occupational medical protection measures to reduce risk exposure factors.

• Korean Journal of Radiology
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• 제25권3호
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• pp.277-288
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• 2024

Objective: We previously found that the incidence of sarcopenia increased with declining glucose metabolism of muscle in patients with treatment-naïve diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the relationship between sarcopenia and muscle glucometabolism using ¹⁸F-FDG PET/CT at baseline and end-of-treatment, analyze the changes in these parameters through treatment, and assess their prognostic values. Materials and Methods: The records of 103 patients with DLBCL (median 54 years [range, 21-76]; male:female, 50:53) were retrospectively reviewed. Skeletal muscle area at the third lumbar vertebral (L3) level was measured, and skeletal muscle index (SMI) was calculated to determine sarcopenia, defined as SMI < 44.77 cm²/m² and < 32.50 cm²/m² for male and female, respectively. Glucometabolic parameters of the psoas major muscle, including maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), were measured at L3 as well. Their changes across treatment were also calculated as ΔSMI, ΔSUVmax, and ΔSUVmean; Δbody mass index was also calculated. Associations between SMI and the metabolic parameters were analyzed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified. Results: The incidence of sarcopenia was 29.1% and 36.9% before and after treatment, respectively. SMI (P = 0.004) was lower, and sarcopenia was more frequent (P = 0.011) at end-of-treatment than at baseline. The SUVmax and SUVmean of muscle were lower (P < 0.001) in sarcopenia than in non-sarcopenia at both baseline and end-of-treatment. ΔSMI was positively correlated with ΔSUVmax of muscle (P = 0.022). Multivariable Cox regression analysis showed that sarcopenia at end-of-treatment was independently negatively associated with PFS (adjusted hazard ratio [95% confidence interval], 2.469 [1.022-5.965]), while sarcopenia at baseline was independently negatively associated with OS (5.051 [1.453-17.562]). Conclusion: Sarcopenic patients had lower muscle glucometabolism, and the muscular and metabolic changes across treatment were positively correlated. Sarcopenia at baseline and end-of-treatment was negatively associated with the prognosis of DLBCL.

• The Korean Journal of Pain
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• 제31권2호
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• pp.116-124
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• 2018

Background: We aimed to investigate the prevalence of unrecognized depression in patients with chronic pain, but with no history of psychiatric diseases. Methods: Patients with chronic pain who did not have a history of psychiatric disease were selected for this study. The Beck Depression Index (BDI) was used to evaluate depression. Participants' socio-demographic characteristics and pain-related characteristics were also recorded. Results: The study included 94 consecutive patients with chronic pain (28 men and 66 women). Based on the BDI scores, 33/94 (35.1%) patients with chronic pain had comorbid depression. The prevalence of depression was significantly higher in our cohort than it was in the general population (P < 0.001). The standardized incidence ratio, adjusted for age and sex, was 2.77 in men and 2.60 in women. Patients who were unmarried (odds ratio [OR] = 3.714, P = 0.044), and who had subjective sleep disturbance (OR = 8.885, P < 0.001), were more likely to have moderate to severe depression. Patients with high education levels (OR = 0.244, P = 0.016), and who were economically active (OR = 0.284, P = 0.023), were less likely to have moderate to severe depression. Conclusions: Our results indicate that unrecognized depression in patients with chronic pain is common. Therefore, pain physicians should actively seek to identify these problems rather than relying on the patient to volunteer such information.

• 한국치위생학회지
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• 제14권4호
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• pp.593-599
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• 2014

Objectives : Latex gloves hygiene is the most effective method to prevent infection of microorganisms and to reduce the incidence of cross infections. The aim of this study was to compare the bacteria reduction ratio of cleansing with water, liquid soap and alcohol gauze. Methods : The left side glove was the control group and the right side was the experimental group. The experimental group washed hand with water, soap, and alcohol gauze. The hand plate was inoculated by the hand and inoculated for 24 hours in $35^{\circ}C$. Results : Washing with water showed that CFU of control group was 1116.9 and that of experimental group was 302.8. Hand washing by water reduced 74.3% of bacteria. Liquid soap revealed that CFU of control group was 619.9 and that of experimental group was 8.3. Hand washing by liquid soap reduced 97.5% of bacteria. Alcohol gauze included 875.2 CFU in control group and 5.8 CFU in experimental group. Washing by alcohol gauze reduced 99.5% of bacteria. Conclusions : Based on the results, the most effective latex gloves cleansing method was recommended as the standardized hand washing with the liquid hand soap and alcohol gauze. The results can be used to improve training strategies for enhancing glove hygiene practice in dental clinic.