BACKGROUND: This study aimed to estimate the burden of acute pesticide poisoning and to determine its trend with recently implemented pesticide regulations. METHODS: Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs) due to acute pesticide poisoning using the methods of the Global Burden of Disease Study 2013. The values of YLLs, YLDs, and DALYs were stratified by sex, age groups, intentionality of poisoning, and causative agents. RESULTS: From 2006 to 2014, DALYs decreased by 69% (from 69,550 to 21,742). The decreasing tendency of DALYs was especially marked from 2011. The total burden of acute pesticide poisoning was mainly caused by YLLs and intentional pesticide poisoning. The highest DALYs due to acute pesticide poisoning occurred in those in their 40s and 50s; however, the decreased rates of DALYs were higher in those aged 10–49 years than in those aged more than 50 years. Herbicides including paraquat contributed to the largest proportion of total DALYs. CONCLUSION: As this is the first study to quantify the burden of acute pesticide poisoning using DALYs, our results provide comprehensive evidence of the importance of using strict regulations to prevent public health hazards due to acute pesticide poisoning.
Agrochemicals ; Cost of Illness ; Herbicides ; Humans ; Intention ; Korea* ; Paraquat ; Poisoning* ; Public Health ; Social Control, Formal ; Suicide

BACKGROUND: Although HIV is introduced relatively late into Asia, the amount of HIV-positive population has been continuously growing in this area. UNAIDS/WHO estimate that 6.5 million people are living with HIV in the Asia/Pacific region at the end of 1999. To expect the HIV/AIDS epidemic in the 21st century in Korea, it is necessary to monitor the changes of the number of newly found HIV-infected individuals and their immune status by year including their epidemiological data. METHODS: We have selected 591 HIV-infected individuals whose first CD4 count was checked within 6 months from the time of diagnosis of HIV infection from 1990 to 1999. For the measurement of CD4+T and CD8+T cells, blood samples of HIV-1 infected individuals were collected into three potassium ethylene diamine tetra-acetic acid (K3EDTA)-treated tubes and stained within at least 24 hours after drawing and analysed by flow cytometer (FACStar or FACScount). The immune status were classified into 4 groups as follows: group I (> or =500 CD4+T cells/mm3), group II (201~499 CD4+T cells/mm3), group III (51~200 CD4+T cells/mm3), and group IV (< or =50 CD4+T cells/mm3). RESULTS: The mean of number of CD4+T cells of HIV-infected individuals at the time of HIV diagnosis was 677 cells/mm3 and the percentage of CD4+T cells was 22.5% in 1990~1991 but 350 cells/mm3 and 14.7% in 1999, respectively. The number of newly found HIV-infected individuals belong to Group III increased rapidly from 1997 to 1999. Also, the proportion of newly found HIV-infected individuals having the CD4+T cell counts of < or =50 cells/mm3 increased slowly by the time of diagnosis of HIV infection. The proportion of newly found HIV-infected individuals who were found in general hospitals increased during the second half of the 1990s. CONCLUSION: These results show that not only the number of newly found HIV-infected individuals has increased annually but also their immune status at the time of HIV diagnosis have been more depressed by the year. Therefore, we should enforce education for prevention of HIV/AIDS about general population as well as high risk groups.
Asia ; Blood Cells ; CD4 Lymphocyte Count ; Cell Count ; Diagnosis ; Education ; HIV Infections ; HIV* ; HIV-1 ; Hospitals, General ; Korea ; Potassium

BACKGROUND: Apo E lipoprotein is polymorphic and exists in three common isoforms (E2, E3 and E4), which are the gene products of three apo E alleles, e2, e3 and e4. Apo E lipoprotein plays an important role in the regulation of the lipid metabolism through its ability to bind to receptors. Depending on the genotypes apo E polymorphism is either protective or increases risk for atherosclerosis and coronary artery disease. The purpose of this study is to evaluate 1) the association between apo E allele and the development of coronary artery disease, 2) the association between apo E alleles and dyslipidemia in Korean males. METHODS: We studied 241 patients with angiographically verified coronary artery disease and 257 male subjects without evidence of coronary artery disease. Apo E genotyping was determined with the INNO-LiPA Apo E kit (Innogenetics, Belgium), which is based on reverse hybridization. RESULTS: There was a higher frequency of the apo e4 allele in subjects with coronary artery disease than in normal controls. The frequencies of apo E genotype were not significantly associated with apo e2 were associated with higher levels of triglyceride and lower LDL, and the subjects with apo e4 had lower levels of HDL cholesterol. CONCLUSION: ApoE polymorphism is a genetic marker for risk of the development of coronary artery disease and an important determinant of dyslipidemia.
Alleles ; Apolipoprotein E2 ; Apolipoprotein E4 ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Cholesterol, HDL ; Coronary Artery Disease* ; Coronary Vessels* ; Dyslipidemias ; Genetic Markers ; Genotype ; Humans ; Lipid Metabolism ; Lipoproteins ; Male* ; Protein Isoforms ; Triglycerides

PURPOSE: This report attempts to reveal the incidence and prevalence of bronchopulmonary dysplasia (BPD) and compare the severity according to preceding causes of BPD in very low birth weight (VLBW) infants. METHOD: Retrospective study was done on 293 VLBW infants who were born and admitted to neonatal intensive care unit in Samsung medical center between October, 1995 and December, 2001. Classical BPD was defined as oxygen dependency at 36 week's postmenstrual age (PMA). Ogawa BPD was defined as oxygen dependency at 28 days after birth, with respiratory distress symptoms and the change on chest X-ray finding. This classification further classified as BPD into 5 subtypes by the presence of respiratory distress syndrome (RDS), pathologic chorioamnionitis and the type of chest X-ray finding. BPD by Jobe and Bancalari was defined as oxygen dependency at 28 days after birth and classified as 3 subtypes (severe, moderate, mild) by the severity of oxygen dependency. Comparisons were made among classifications. RESULTS: Classical BPD infants were 56 (19.1%), Ogawa BPD infants were 76 (25.9 %), BPD by Jobe and Bancalari infants were 124 (42.3%). In Ogawa classification, Infants with RDS and the change on chest X-ray were 58 infants (76.4%). There was no statistical difference of mortality between each type of Ogawa BPD. In classification by Jobe and Bancalari, 35 infants (28.2%) belonged to severe BPD and 75 infants (60.5%) belonged to mild BPD. The mortality was highest in severe BPD infants but there was no statistical difference after correction by birth weight. There was no statistical correlation between Ogawa classification and classification by Jobe and Bancalari. CONCLUSION: There was no statistical difference in mortality or severity between each subtype of classifications according to the severity or preceding cause of BPD in very low birth weight infants.
Birth Weight ; Bronchopulmonary Dysplasia* ; Chorioamnionitis ; Classification ; Female ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Mortality ; Oxygen ; Parturition ; Pregnancy ; Prevalence ; Retrospective Studies ; Thorax

PURPOSE: Cytomegalovirus(CMV) infection still remains as a major cause of morbidity and mortality after stem cell transplantation. In this study, we analyzed the results of antigenemia-guided pre-emptive therapy among children with allogeneic hematopoietic stem cell transplantation to determine the incidence and risk factors associated with CMV antigenemia, and evaluated the efficacy of the CMV antigenemia based preemptive therapy. METHODS: We enrolled 213 pediatric patients following allogeneic hematopoietic stem cell transplantation(HSCT), at the Catholic HSCT center between October 1998 and December 2003. Pre-emptive ganciclovir was started when more than 5 CMV Ag-positive cells were detected in matched sibling HSCT, and when any Ag-positive cells were seen in unrelated allogenic HSCT. RESULTS: CMV antigenemia was observed in 88(41.3 percent) of 213 patients on median day 28(day 11-99). In univariated analysis, use of unrelated donors(other than siblings), age of recipient(more than 5 years at transplant) at transplantation, the presence of recipient CMV-IgG before transplantation, TBI-based conditioning regimen and the presence of acute GvHD(grade > or=II) were the risk factors for positive CMV antigenemia. In multivariate analysis, unrelated bone marrow transplantation, positive recipient CMV serology and acute GvHD(grade > or=II) were the independent risk factors for positive CMV antigenemia. CONCLUSION: Risk factors of CMV infection in children were CMV serostatus of the recipient, the source of stem cells, and acute graft-versus-host disease. The pre-emptive therapy based on CMV antigenemia was effective in the prevention of CMV disease.
Bone Marrow Transplantation ; Child ; Cytomegalovirus ; Ganciclovir ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells* ; Humans ; Incidence ; Mortality ; Multivariate Analysis ; Risk Factors ; Siblings ; Stem Cell Transplantation ; Stem Cells

We have designed a five-year multicentre prospective cohort study in women who are both human papillomavirus (HPV)-positive with either atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) of cervix. This study aimed to analyze the risk of developing a high-grade squamous intraepithelial lesion (HSIL) from either ASCUS or LSIL in HPV-positive women, so called 'progression' rate, to investigate differences in the progression rates according to HPV type-specific infection, and to evaluate the various factors associated with the persistence or clearance of HPV infection in the Korean population. At present, the study protocol composed of cervical cytology, HPV DNA testing, and questionnaire have been conducted actively since the first participant was enrolled in 2010. This study is the first nationwide Korea HPV cohort study. Our data will provide valuable information about not only the ambiguous cytology results of ASCUS and LSIL but also the effect of the specific HPV type and other various factors on the progression to HSIL. Finally, the results of our study will be helpful and applicable to determine the primary cervical cancer prevention strategies.
Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Cohort Studies ; Female ; Human Papillomavirus DNA Tests ; Humans ; Korea ; Uterine Cervical Neoplasms ; Surveys and Questionnaires

PURPOSE: We investigated the change in serum total immunoglobulin E (IgE) and allergen-specific IgE according to allergic diseases and age. METHODS: Allergic markers of children under 18 years of age with allergic diseases for the last 5 years were collected from 12 hospitals nationwide. The total data was 9,710. Data about levels of serum total IgE and allergen-specific IgE to 15 common allergens were collected. RESULTS: In children with asthma, serum total IgE was higher in older age than in younger age until age 7 to 12 years, at which time the level was highest (paper radioimmunosorbent test, 526.7 IU/mL; UniCAP, 339.9 IU/mL). The level was lower in older age than that during younger age. This change was similar to that in children with allergic rhinitis and atopic dermatitis. The level was highest at ages 7 to 12 years in children with allergic rhinitis, and at age 10 to 12 years in children with atopic dermatitis. In children with both asthma and allergic rhinitis, as well as in children with all three diseases, the change in serum total IgE was similar to that of children with an isolated disease. The highest level in children with all three diseases was higher than that in children with an isolated disease. The analysis of allergen-specific IgE positivity showed that food allergens were dominant before the age of 2 years, and that aeroallergens such as house dust mites were dominant. CONCLUSION: Serum total IgE in Korean children with allergic diseases was higher in older age than in younger age until the ages of 7 to 12 years, and then the change in total IgE by age was the opposite.
Allergens ; Asthma ; Child ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Immunoglobulin E ; Immunoglobulins ; Korea ; Pyroglyphidae ; Radioimmunosorbent Test ; Rhinitis ; Rhinitis, Allergic, Perennial

PURPOSE: The nature of allergic rhinitis (AR) in preschool aged children remains incompletely characterized. This study aimed to investigate the prevalence of AR and its associated risk factors in preschool-aged children and to assess the clinical utility of fractional exhaled nitric oxide (FeNO). METHODS: This general population-based, cross-sectional survey included 933 preschool-aged (3- to 7-year-old) children from Korea. Current AR was defined as having nasal symptoms within the last 12 months and physician-diagnosed AR. RESULTS: The prevalence of current AR in preschool children was 17.0% (156/919). Mold exposure (adjusted odds ratio [aOR], 1.67; 95% confidence interval [CI], 1.15-2.43) and the use of antibiotics (aOR, 1.97; 95% CI, 1.33-2.90) during infancy were associated with an increased risk of current AR, whereas having an older sibling (aOR, 0.52; 95% CI, 0.35-0.75) reduced the risk. Children with current atopic AR had significantly higher geometric mean levels of FeNO compared to those with non-atopic rhinitis (12.43; range of 1standard deviation [SD], 7.31-21.14 vs 8.25; range of 1SD, 5.62-12.10, P=0.001) or non-atopic healthy children (8.58; range of 1SD, 5.51-13.38, P<0.001). The FeNO levels were higher in children with current atopic AR compared with atopic healthy children (9.78; range of 1SD, 5.97-16.02, P=0.083). CONCLUSIONS: Mold exposure and use of antibiotics during infancy increases the risk of current AR, whereas having an older sibling reduces it. Children with current atopic AR exhibit higher levels of FeNO compared with non-atopic rhinitis cases, suggesting that FeNO levels may be a useful discriminatory marker for subtypes of AR in preschool children.
Anti-Bacterial Agents ; Child ; Child, Preschool* ; Cross-Sectional Studies ; Fungi ; Humans ; Korea ; Nitric Oxide ; Odds Ratio ; Prevalence ; Rhinitis ; Rhinitis, Allergic* ; Risk Factors ; Siblings