While there have been not a few reports on the seroepidemiological characteristics of hepatitis B virus (HBV) infection in Korea, most of them, however, have had several limitations; operational definition of HBV infection, validity of detection methods of HBV serologic markers, size of the study population, and confirmation of the vaccination history against HBV, etc. In order to avoid such limitations, authors randomly selected 1,495 healthy adults among the 217,511 insured (target population) of Korean Medical Insurance Corporation, living in seoul, and tested HBV(HBsAg, anti-HBs and anti-HBc) of all the subjects were tested, 392(26.2%) of interview failure cases 742 nonvaccinee were excluded from the actual population. Finally, the serologic markers tested of 742 nonvaccinee (study population) only were analyzed for the seroepidemiologic observation of the natural infection of HBV. The seroepidemiological characteristics of HBV infection in Korea were as follows ; 1 Point prevalence of HBs antigenemia was 11.7(9.1-14.3)% in male, which was slightly higher than that of female, 9.5(3.7-15.3)%. This level was one of the highest among those of Asian-Pacific countries. Decreasing tendency of HBsAg prevalence after the age of 50 was observed, which seems to be due to selective attrition of HBV chronic carriers among the healthy adults and/or to the limited-lasting duration of the HBs antigenemia, in part. 2. Point prevalence of anti-HBc(78.8% in male, 50.9% in female) was higher than that of anti-HBs(65.2% in male, 46.6% in female), respectively. And both of them were higher in male than in female. Increasing tendency of the prevalence of both antibodies was observed by age, which seems to be largely due to recurrent infection in adults and to some cumulative effect, in part, of their relatively longer-lasting duration. 3. The level of HBV infection defined by positive for at least one of the 3 serologic markers of HBV by RIA method was 84.7(81.8-87.6)% in male and 61.2(51.9-70.5)% in female, which was also one of the highest among those of Asian-Pacific countries. The proportion of susceptible population to HBV infection among healthy adults was 15.3% in male and 38.8% in female. 4. The relative frequency of current or past infection and chronic carrier among HBV infected person was estimated. The currently or past infected was estimated 75.7% in male and 71.8% in female, and chronic carrier state, 13.8% in male and 14.1% in female. The analysis of the geometric mean of the antibody titer in anti-HBs positive sera indicated also to be compatible with the above findings, suggesting that active, even though inapparent, infection of HBV occur so frequently among healthy adults in Korea.
Adult* ; Antibodies ; Carrier State ; Female ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Insurance ; Korea ; Male ; Prevalence ; Radioimmunoassay ; Seoul* ; Vaccination

The aim of this study was to assess the degree of association between individual stress and the amount of smoking among male senior students of a medical college. The questionnaire survey was conducted twice for collecting the data on stress level in terms of BEPSl score, smoking amounts, alcohol intake, and residence type in 1992 and 1993. Among the 223 responders, 39.9% were smokers. In the smokers, the association between stress level and smoking amount was significant after controlling for alcohol intake and residence type (P < 0.l). Especially in the group of living without family, the association was more significant (p=0.06). Therefore, it is recommendable that the stress management program is called upon for the student smokers to reduce smoking amount.
Humans ; Male ; Surveys and Questionnaires ; Smoke* ; Smoking*

No abstract available.
Coxa Vara* ; Follow-Up Studies*

Pneumoperitoneum associated with a pneumothorax, pneumomediastinum, and subcutaneous emphysema during intubation and positive ventilation has rarely been reported. In general, such a pneumoperitoneum requires conservative treatment; therefore, it should be distinguished from pneumoperitoneum associated with a hollow viscus perforation. Our case involved a 47-year-old man treated with intubation and positive ventilation for the maintenance of airway patency. Not only a pneumothorax, pneumomediastinum and subcutaneous emphysema but also free intra-abdominal gas was observed on the chest X-ray. No evidence of a hollow viscus perforation was found on physical examination and the upper gastrointestinal series. The patient was treated conservatively for 10 days; then, the pneumoperitoneum, the pneumothorax, the pnenumomediastinum, and the subcutaneous emphysema disappeared. In this report, we reviewed the clinical significance and the anatomical relation of pneumoperitoneum associated with a pneumothorax, pneumomediastinum, and subcutaneous emphysema.
Humans ; Intubation* ; Mediastinal Emphysema* ; Middle Aged ; Physical Examination ; Pneumoperitoneum* ; Pneumothorax* ; Subcutaneous Emphysema ; Thorax ; Ventilation*

BACKGROUND: The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart anomalies. So, at the moment, it is believed that avoidance of suspected environmental factors in early pregenancy is most certain preventive measure of congenital heart anomalies. This study has been undertaken in order to find the possible environmental risk factors for congenital heart anomalies in Korea. METHOD: A total of 320 mothers of infants with congenital heart anomalies diagnosed at Seoul National University Hospital were included in this study as case group. And 413 mothers of healthy infants, who visited well baby clinic at the hospital during the same period of 2 years from 1987, comprised the control group. Data related to environmental risk factors including drug use during the first trimester of pregnancy, any other confounders were collected by direct interview using questionmaires. RESULT: There were positive associations for lower educational level of mother, indoor smoking habit of father, number of pregnancy, and of experience of previous abortion of mother, and multiple(or twin) birth. Relative risk estimates for the first trimester exposure to anti-emetics and herb medicine were 2.1(p<0.006) and 1.4(p<0.044), respectively. Data showed a positive association between anti-inflammatory drug exposure and congenital anomalies of pulmonary valve(OR=22.7, p<0.01), and between anti-histamine exposure and coarctation of aorata(OR=12.7, p<0.017). CONCLUSION: Environmental factors such as smoking habit of father, certain drugs used in early pregnancy, plays a role in the etiology of congenital heart anomlaies. Further studies, designed to focus on specific drug and to differentiate the effect of the suspected drug and to differentiate the effect of the suspected drug form that of the underlying conditions prompting its use, should be called upon.
Abortion, Induced ; Antiemetics ; Case-Control Studies* ; Fathers ; Female ; Heart* ; Humans ; Infant ; Korea* ; Mothers ; Parturition ; Pregnancy ; Pregnancy Trimester, First ; Risk Factors ; Seoul ; Smoke ; Smoking

BACKGROUND: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. METHODS: Study subjects were drawn from male members of seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hundred per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. RESULTS: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. CONCLUSION: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.
Adult* ; Case-Control Studies ; Cohort Studies ; Drinking ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Liver Diseases* ; Liver* ; Logistic Models ; Male* ; Obesity ; Odds Ratio ; Pharmacoepidemiology ; Postal Service ; Surveys and Questionnaires ; Seoul ; Smoke ; Smoking

Korean versions of British Medical Research Council (MRC), Cornell 1V, Mgdical Index(CMI), and American Thoracic Society 78 (ATS-DLD-78) respiratory questionaires were compared with each other, and were tested the stability, in terms of test-retest reliability, of each questions by self-administration of those to 156 medical students. The results obtained and conclusions drawn are as follow: 1. The degree of agreements between responses to the comparable questions of CMI vs MRC, and of CMI vs ATS-DLD-78 were not satisfactory. There were, however, 71~100 per cent of agreement between responses to the questions on Cough, Wheezing, Phlegm, Breathlessness, and Chest illness of ATS-DLD-78 vs MRC questionaire. And the ATS-DLD-78 tended to yield greater number of positive responses than MRC (See Table 4). 2. All of the coefficient of stability of each questions in 3 questionaires were statistically significant, ranged 77~100 per cent, except that of the question on episode' of cough and phlegm in ATS-DLD-78 questionaire (See Table 5-1). The question is composed of two collateral conditions, "lasting for 3 weeks or more" and "each year". 3. It can be insisted that the Section-B questions of CMI is not proper for use in epidemiologic survey on respiratory illness. And rather than MRC, the ATS-DLD-78 questionaire deserves to prefer to be used in epidemiologic studies on respiratory illness. 4. In question-wording, especially, of inquiring past experience, it is possible to Iessen the reliability of the question that including collateral conditions such as 'the duration lasted of symptoms', and moreover, of which words are not common usage. For example, for Korean '10-days' or 'half a month' is more familiar time unit rather than 'week'.
Cough ; Humans ; Respiratory Sounds ; Students, Medical ; Thorax

A clinical study on the antihypertensive effect of long-acting propranolol was performed in 25 patients with essential hypertension. Following a week treatment of the subjects with the regimen of propranolol 40mg twice a day during the first week, 160mg of long-acting propranolol was given once a day for the subsequent 4 weeks. At the end of the fifth week, in 8 out of 25(32%) blood pressures were lowered to the level of 140/90 mmHg or lower, in another 8(32%) the blood pressures were lowered by 20 mmHg or more of systolic and/or 10mmhg or more of the diastolic pressures. Eleven out of 12 subjects, whose blood pressures had been significantly lowered at the end of the first week of propranolol treatment, manifested significant blood pressure lowerings also at the end of 4 weeks' long-acting propranolol treatments. Long-acting propranolol had beneficial effect of ameliorating anginal pain in 2 subjects who had had angina pectoris before the beginning of hypertension. Adverse side eiffects observed were mild fatigue in one, indigestion in one and sinus bradycardia in another one.
Angina Pectoris ; Blood Pressure ; Bradycardia ; Dyspepsia ; Fatigue ; Humans ; Hypertension ; Propranolol

The survey methods for confirming the epidemicity and identifying the possible causes of the cancer epidemic can be different from those for infectious diseases. The procedure for confirming whether the outbreak is epidemic or not is quite different. Household survey for identifying cancer cases and residents actually living at the area should be done. Hospital survey for medical record review should be performed to identify all cancer cases among the residents of the outbreak area and confirming the final diagnoses of the cancer cases. Comparing the level of cancer incidence or mortality with other areas can be done by using poison distribution, or calculating SIR (standard Incidence Ratio) from cumulative incidence rates. Case-control study can be conducted to identify the etiologic factors of the cancer epidemic and to establish strategy for preventing further recurrence of the outbreak.
Case-Control Studies ; Communicable Diseases ; Surveys and Questionnaires* ; Diagnosis ; Epidemiology ; Family Characteristics ; Incidence ; Medical Records ; Mortality ; Recurrence

OBJECTIVES: The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea. METHODS: In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score. RESULTS: Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively. CONCLUSIONS: Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.
Adult ; Alcohol Drinking/mortality ; Body Mass Index ; *Cause of Death ; Cohort Studies ; Exercise/physiology ; Follow-Up Studies ; *Health Behavior ; Humans ; Korea ; Life Style ; Male ; *Men's Health ; Middle Aged ; Proportional Hazards Models ; Risk Factors ; Smoking/mortality