OBJECTIVES: The mortality rate due to stroke and myocardial infarction by the complication of the hypertension were the major causes of death among the Korean followed by the cancer. There are many factors to affect the blood pressure variability such as physical activity, sleeping, activation of the autonomic nervous system, climate, cold exposure and seasonal variation. The blood pressure was increased by cold exposure. In general, blood pressure was increased in winter and the cardiovascualr mortality is also increased at winter. In Korea, we have distinct seasonal variation of the climate, we have no clinical data on the seasonal variation of the blood pressure. METHODS: To investigate the seasonal variation of blood pressure of Korean essential hypertensives and make effort to reduce the cardiovascualr mortality, we studied 63 hypertensive men and women hypertensives. RESULTS: 1) The mean age was 60+/-10 years with 19men and 44 women. The mean systolic blood pressure was 146+/-22mmHg, mean diastolic blood pressure was 91+/-11mmHg. 2) The mean systolic and diastolic blood pressure during the 12 months was 137+/-18mmHg, 86+/-10mmHg in men respectively. In women, the mean systolic blood pressure was 137+/-16mmHg and the mean diastolic blood pressure was 86+/-8mmHg. 3) The biochemical findings including hemoglobin, hematocrit and creatinine levels were significantly lower in women(P<0.05). 4) The systolic and diastolic blood pressure were significantly increased during the winter as January and February, 5) There was also significant increase of systolic blood pressure at the transitional zone to the sum- mer to autumn(P=0.0004). CONCLUSION: There was significant increase in systolic and diastolic blood pressure in winter in Korean hypertensives. This phenomenon was also observed the transitional zone to summer to autumn. So, during these period, more strict blood pressure control by frequent measurement and increase the room temperature may be recommended to reduce the cardiovascular mortality during winter.
Autonomic Nervous System ; Blood Pressure* ; Cause of Death ; Climate ; Cold Climate ; Creatinine ; Female ; Hematocrit ; Humans ; Hypertension ; Korea ; Male ; Mortality ; Motor Activity ; Myocardial Infarction ; Seasons* ; Stroke

BACKGROUND: Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of air pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. METHOD: This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i.e., mainly potential environmental diseases. We reconstructed a nested case-control study with Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects'. Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are probable chronic environmental diseases, while controls are mainly acute environmental diseases. For exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, O3, SO2, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results: Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-attainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of O3and CO exceedance counts(to corrected error level - 0.017) and less strongly and consistently with SO2 and TSP. SO2and TSP showed weaker and less consistent relationship. O3and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). CONCLUSIONS: Although not decisive due to potential misclassication of exposure, these results were drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. O3might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.
Air Pollutants ; Air Pollution* ; Asthma ; Bronchitis, Chronic ; Cardiovascular Diseases ; Case-Control Studies ; Cohort Studies ; Information Storage and Retrieval ; Environmental Monitoring ; Heart ; Heart Failure ; Humans ; Insurance ; Korea ; Logistic Models ; Lung Diseases, Obstructive ; Lung Neoplasms* ; Lung* ; Motor Vehicles ; Physical Examination ; Pulmonary Disease, Chronic Obstructive* ; Surveys and Questionnaires ; Smoke ; Smoking

BACKGROUND: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2009 through June 2010. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU) at 116 ICUs in 63 hospitals by using KONIS. Nosocomial infection (NI) rates were calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We identified 3,965 NIs during the study period: 2,156 cases of UTIs (2,119 were urinary catheter-associated), 1,110 cases of BSIs (948 were central line-associated), and 699 cases of PNEU (410 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 4.75 cases per 1,000 device-days (95% confidence interval, 4.55-4.95), and urinary catheter utilization ratio was 0.86 (range, 0.859-0.861). The rate of central line-associated BSIs was 3.28 (range, 3.07-3.49), and the utilization ratio was 0.56 (range, 0.559-0.561). The rate of ventilator-associated PNEUs (VAPs) was 1.95 (range, 1.77-2.15), and the utilization ratio was 0.41 (range, 0.409-0.411). Although ventilator utilization ratio was lower in the hospitals with 400-699 beds than in the hospitals with 700-899 beds and more than 900 beds, the rate of VAPs were higher in the hospitals with 400-699 beds than in hospitals with 700-899 beds and more than 900 beds. The incidence of infections due to imipenem-resistant Acinetobacter baumannii increased from 43.6% to 82.5% since July 2006. CONCLUSION: The risk of acquiring VAP and CAUTI is highest in the ICUs of hospitals with 400-699 beds than that in hospitals with more beds. Imipenem-resistant A. baumannii was identified as an emerging gram-negative pathogen of nosocomial infections.
Acinetobacter baumannii ; Cross Infection ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

This cohort study is a collaborative effort of 8 institutions. The goal is to establish a large scale cohort that can be followed for 10 or more years to assess the relationship between life-styles and cancer occurrence, and to evaluate the role of environmental exposures in the development of six major sites of cancers(stomach, liver, lung, colorectum, uterine cervix and female breast) in the rural population. Since 1993, 11,304 men and women aged over 35 living in four areas have been recruited. The number of target population is 30,000 persons, which is expected to be successfully recruited until 1999. Each subject has completed a detailed questionnaire on general life-styles, reproductive factors, and agricultural chemical exposures through the interview. Anthropometric measurements with body fat composition and the routine clinical laboratories were examined. For the cancer-free cohort, physical examination by the physicians and serologic tests for hepatitis markers, some tumor markers, and lipid profile have been done, but not all. In order to provide an opportunity to incorporate barious biomarkers of exposure and effect as well as genetic susceptibility, a biologic tissue bank has been established from blood and urine sample(plasma, WBC buffy-coat, RBC clots, and urine supernatant) stored at-70degrees C. Re-examination of changes in exposere to risk factors will be done periodically. Disease occurrence will be ascertained by the active(mainly through diagnosis by physicians) and the passive surveillance(through both death certificate and screening of medical utilization records).
Adipose Tissue ; Biomarkers ; Cervix Uteri ; Cohort Studies* ; Death Certificates ; Diagnosis ; Environmental Exposure ; Female ; Genetic Predisposition to Disease ; Health Services Needs and Demand ; Hepatitis ; Humans ; Korea* ; Liver ; Lung ; Male ; Mass Screening ; Physical Examination ; Risk Factors ; Rural Population ; Serologic Tests ; Tissue Banks ; Biomarkers, Tumor ; Surveys and Questionnaires