OBJECTIVE: To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. METHODS: From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. RESULT AND CONCLUSION: Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).
Alcohol Drinking ; Birth Order ; Chronic Disease ; Cohort Studies* ; Education ; Female ; Humans ; Korea ; Menopause* ; Middle Aged ; Mortality ; Odds Ratio ; Proportional Hazards Models ; Smoke ; Smoking

OBJECTIVES: This study was to investigate the mental health status and quality of life of Korean-Chinese workers, who are residing illegally in Korea. METHODS: Total 147 illegal status Korean-Chinese workers completed to the questionnaire for demographic data, Korean version of Symptom Check List-90-Revision (SCL-90-R) and Korean version of World Health Organization Quality of Life Scale (WHOQOL-BREF). RESULTS: The results of this study showed that general mental health was relatively poor and the quality of life was relatively poorer among Korean-Chinese. Mental health and quality of life were worse among those who accompanied spouses, had no religion, had less income, and those who experienced unjust treatments such as delayed payment, violence and industrial accidents. There were significant correlations between scores of all categories of SCL-90-R and scores of domains of physical health, social relationship and environment in WHOQOL-BREF. CONCLUSION: These results suggest that Korean-Chinese laborers in illegal status in Korea need improved treatment neleved from delayed payment, social violence and industrial accidents and with extended medical service and better residential environment.
Accidents, Occupational ; Humans ; Korea* ; Mental Health* ; Quality of Life* ; Surveys and Questionnaires ; Spouses ; Violence ; World Health Organization

This study aims to suggest potential steps required for the integration of medical and oriental medical school by comparing the curriculum and its content between the two. The analysis was based on the specific behavioral objectives(SBOS) of the Korean Medical Association and Oriental Medical School Association. We used the school's catalog as well to get information on courses that are offered, hours, and credits. Major findings were as follows. 1. Clinical courses that are taught in oriental medical schools cover about 75% of the courses offered in medical schools on the basis of SBOS. This suggests that western medical knowledge is required for training oriental medical doctors in Korea. 2. If the SBOS of clinical medicine is taught for another 1 year at the oriental medical school, it will cover the entire content of the medical school. Also if 1.5 years of oriental medicine content is taught at medical school, it will include the whole SBOS offered in orienta medical school. Including a 1 year of clinical practicum, the extra years of required education would be 2 years for oriental medical students and 2.5 years for the medical students. Planning for an integrated for medical and oriental medicine requires close cooperation between all parties in practice and academics. A newly developed level of medicine will emerge from this if the plan takes into account the establishment of medical and oriental medical graduate schools and KMA's movement to reduce the number of SBOS to be taught in medical schools.
Clinical Medicine ; Curriculum* ; Education ; Humans ; Korea ; Medicine, East Asian Traditional ; Schools, Medical* ; Students, Medical

OBJECTIVES: This paper presents the information on the incidence of cancer from the population-based cancer resistry in Kangwha County. Material and METHODS: This investigation is based on Kangwha cancer registry. The data included cases of cancer diagnosed from 1986 through 1992. The diagnosis of cancer was confirmed by a team of physicians and nurses with the medical records kept in the clinics and hospitals based on the diagnostic criteria recommended by WHO. Home visitings were also made to cancer patients confirmed in every 6 months for the follow up and for the collection of relevant information directly from the patients. RESULTS: A total of 992 cancer cases were registered during 1986 - 1992. The age-adjusted cancer incidence rate of all site is 201.7 in men and 110.7 in women. The most common cancer is the stomach cancer in both sexes. The age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population. The lung cancer(33.8) and liver cancer(27.7) are next common cancers in men. The cervical cancer(21.8) and lung cancer(8.4) are next in women. CONCLUSION: The most common cancer is the stomach cancer in both sexes. The annual age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population.
Diagnosis ; Female ; Follow-Up Studies ; House Calls ; Humans ; Incidence* ; Liver ; Lung ; Male ; Medical Records ; Stomach Neoplasms

Since 1998, Yonsei University College of Medicine attempted a curriculum reform focusing on clinical clerkship. The reform concentrated on the next three categories; (1) minor clinical courses following major clinical courses, (2) selecting 9 minor clinical courses out of 18, (3) introducing 'Specialized Elective Course' at the first semester of fourth year of medical school. The opinions from students and teachers on such matter were taken into consideration. The study draws its conclusion as follows; first, 'Specialized Elective Course' satisfy students' learning disposition and give guidance in shaping one's career. Second, taking the major clinical course prior to minor clinical courses give students integrated clinical experience and closer connection among the subjects. Third, switching the minor course into elective course provide expanded choice of course selection and reinforce students' motivation to learn. In general, the last two years of the new clinical clerkship showed a satisfactory result. Nevertheless, successive effort of preparing alternative measures should be made regarding the negative opinions in part. In order to do this, a school wide support system must be carried out along with the continuing interest from the students and teachers. The new attempt and study of such curriculum will outgrow the uniform and rigid education, reflecting upon the differences among students and learning goals, which ultimately help medical education to be more successful.
Clinical Clerkship* ; Curriculum ; Education ; Education, Medical ; Humans ; Learning ; Motivation ; Schools, Medical

OBJECTIVE: The aim of this study was to identify the validity of recruiting medical checkup participants of Vietnam veterans using a mail survey, and to identify the 'Vietnam service related characteristics' and `general characteristics' of Vietnam veterans groups. METHOD: In this study, a total 900 veterans were randomly selected from the list of Vietnam veterans from 1964 to 1973. The veterans were classified into 5 groups, taking into consideration their registered status in the Ministry of Patriots and Veterans Affairs; the VRD (veterans who have agent orange-related diseases), VSD (veterans who have agent orange-suspected disease), VM (veterans who performed meritorious deeds during the war), VR (veterans who were registered with the Ministry of Patriots and Veterans Affair) and OV (other veterans) groups. By means of postal surveys, the veterans' intention to participate in the medical checkup for our research, and their socioeconomic and general characteristics were investigated. 52 surveys were returned due to the subjects not residing at the listed address, and were excluded from the analysis. RESULT: 699 of the 848 veterans (82.4%) responded to the survey, of which 619 (88.6%) intended to participate in the medical checkup for our research. The 5 veterans groups all had similar ages, Vietnam service period, Agent Orange exposure, troop characteristic and wartime class, with the exception of VM, who were older, and with a greater number of officers than the other 4 groups. There was a big difference in the health statius among the Vietnam veterans group. The VM and OV were much healthier than VRD, VSD and VR groups. The socioeconomic stati of the VRD, VSD and VR groups were lower than those of the VM and OV groups. CONCLUSION: Although there were some limitations, the recruitment, by mail, of medical checkup participants from Vietnam veterans is a valid and feasible method. The VM and OV groups were much healthier, and with higher socioeconomic stati, than the VRD, VSD, and VR groups.
Citrus sinensis ; Humans ; Intention ; Methods ; Pilot Projects* ; Postal Service* ; Veterans* ; Vietnam*

One of the most important teaching methods in medical education is the holistic approach which tries to integrate basic sciences and clinical medicine. The purpose of this study is to survey the situation of integrative l ectures at Yonsei University, College of Medicine. The study identified some problems in integrative lectures. Most of residents and students do not recognize the nature of integrative lectures. Besides the survey showed that the collaboration between faculty members and departments was uncooperative. Furthermore the intergrative lectures were not able to distinguish from other lectures. The results of present study implies that it is necessary to reevaluate the program of current integrative lectures. To improve the program it is highly recommended to establish the research committee. The committee could organize a variety of seminars and workshops to diseminate information on new teaching strategies in those integrative lectures. Finally, the committee can conduct accessment of existing lectures and modify the curriculum.
Clinical Medicine ; Cooperative Behavior ; Curriculum ; Education ; Education, Medical ; Humans ; Lectures* ; Teaching

The relationship between smoking and total mortality was examined in a community residents population sample of 2,848 men and 3,543 women aged 55 years or over in Kangwha County, Korea during 1985-1991. A total of 1,436 deaths occurred during a 6-year follow-up among the 1.3 fold-higher in current smokers than in non-smokers among men. The relative risk of total mortality was highest for the 55-59 year old age group both in ex-smokers and in current smokers. PAR for total mortality attributed by smoking were estimated to be 26% for ex-smokers and 25% for current smokers in men. The biggest RR (2.1) and PAR (49%) were observed among those who smoked less than 19 cigarettes per day compared to non-smokers in males. Smokers who began to smoke at age 18 or before showed RR 1.8, and PAR 38% in men. Smoking was the most important variable related with total mortality second only to hypertensiveness not including preventable ones among men in multivariate analyses. Men who began to smoke at nineteen years of age or before had RR 1.5 for total cancer mortality. Women showed the similar picture as males in risk factors composition and in relative risks, with a low association strength, however.
Age Factors ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Follow-Up Studies ; Human ; Korea/epidemiology ; Male ; Middle Age ; Multivariate Analysis ; Prospective Studies ; Regression Analysis ; Risk ; Sex Factors ; Smoking/*mortality ; Support, Non-U.S. Gov't

It is not yet clear whether Glutathione S-transferase M1 (GSTM1) polymorphisms affect the risk of breast cancer. The aim of this study is to provide a comprehensive meta-analysis of all the available, published case-control studies on the extent of the possible association between GSTM1 polymorphisms and susceptibility to breast cancer. Twenty case-control studies on GSTM1 and breast cancer were identified using both PUBMED and a manual search. Meta-analysis was conducted by the Peto method. Subgroup analyses were undertaken, in order to explore the relationship between effect sizes and the study characteristics. The overall odds ratio (OR) was found to be 1.06 (95% CI, 0.99-1.14). The OR for post-menopausal women with GSTM1 deficiency was determined to be 1.19 (95% CI, 1.05-1.34). In populations with a low frequency of GSTM1 deficiency, a greater increase was observed (OR, 1.20; 95% CI, 1.08-1.34). Furthermore, the highest associations were found in post-menopausal women with a low frequency of GSTM1 deficiency (OR, 1.44; 95% CI, 1.20-1.73). The fact that GSTM1 deficiency is not rare in the general population implies that the attributable risk for breast cancer could be sizable. Further studies focusing on the structure of haplotype blocks of GSTM1 are required in order to find a specific haplotype with a predisposing breast cancer susceptibility allele.
Breast Neoplasms/*epidemiology/*genetics ; Female ; Glutathione Transferase/*genetics ; Humans ; *Polymorphism, Genetic ; Research Support, Non-U.S. Gov't ; Risk Factors

OBJECTIVES: To propose a feasible, valid and appropriate study designs and epidemiologic methods for evaluating the adverse health effects of Agent Orange-chemical defoliants used in Vietnam- in Korea. METHODS: A literature study was performed on Agent Orange, herbicides, pesticides and dioxins. The study subjects, study design, exposure assessment and health outcomes assessment were examined in each study. The potential data sources for the study subjects, study design, exposure assessment and health outcomes assessment in Korea were investigated. RESULTS AND CONCLUSION: In earlier Korean studies, research subjects for studying the effects of Agent Orange were identified from the patients or persons who claimed to have Agent Orange-related diseases due to the difficulties in identifying the entire population of Vietnam veterans in Korea. In this study, an attempt was made to identify the total number of Vietnam veterans in Korea. As a result, the addresses of 20,000 Vietnam veterans were obtained. It is proposed that a retrospective cohort design on a sample of the total number of Vietnam veterans is a feasible and appropriate study design. Self report questionnaires and military records were proposed to assess the exposure level. It is believed that measuring the plasma or tissue TCDD should be used only for a validation study assessing the level of exposure. For the health outcomes assessment, it is possible to obtain the mortality, cancer frequency, physical examination, screening and medical insurance record data.
Citrus sinensis* ; Cohort Studies ; Data Collection ; Defoliants, Chemical ; Dioxins ; Epidemiologic Methods ; Herbicides ; Humans ; Insurance ; Korea ; Mass Screening ; Military Personnel ; Mortality ; Outcome Assessment (Health Care) ; Pesticides ; Physical Examination ; Plasma ; Questionnaires ; Research Subjects ; Retrospective Studies ; Self Report ; Tetrachlorodibenzodioxin ; Veterans* ; Vietnam*