Since its introduction to Korea from Japan at the beginning of the seventeenth century, tobacco became very popular with an amazing rapidity among Koreans. Along with widespread cultivation of tobacco, smoking also became very popular among Koreans, regardless of their classes, ages, and sexes. On the other hand, other imported crops from America via Europe in the sam period, like sweet potato, potato, corn and tomato, did not enjoy such popularity in Korea. A long time after their introduction, Koreans began to cultivate these crops. Why did Koreans respond enthusiastically to the newly-imported tobacco? What kind of factors contributed to the rapid transmission of tobacco in Korea? This study examined the causes of rapid diffusion of the smoking population in three aspects. First was economic aspect. The farming of tobacco yielded a profit by selling it to Chinese. The climate and the soil of Korea fit for farming of tobacco. So the farm land of tobacco expanded gradually since the 18th century. Second was medical aspect. At first, many Koreans believed that smoking was helpful to digestion, expectoration, protecting coldness, and exterminating parasites. Afterwards, they believed smoking could encourage vitality and protect diseases. There was no reason of smoking cessation for the people's health in that the hazards of smoking were not well known to the commonage in those days, though a few intellectuals acknowledge its harm. Third was sociocultural aspect. We could trace the smoking culture of Chosun dynasty through arts, poems, and essays. The making of smoking culture made stable reproduction of smokers generation by generation. Especially, the smoking culture secured juvenile's smoking. Considering the three aspects above, we know that what reason the Decree of Ban of Smoking in Korea was not strict in comparison to that of China (Qing Dynasty), in which the violators were executed. The regulation of smoking by the government failed except controlling in sociocultural aspect. The government reinforced controlling of smoking culture in counteraction to the threat of collapse of the hierarchy of Chosun dynasty in 18th century.
English Abstract ; History of Medicine, 17th Cent. ; History of Medicine, 18th Cent. ; History of Medicine, 19th Cent. ; Korea ; Smoking/*history ; *Tobacco

PURPOSE: An accurate determination of the natural history of a cerebral aneurysm has implications on management. Few risk factors other than female gender and cigarette smoking have been identified to be associated with cerebral aneurysm progression, particularly rapid progression. MATERIALS AND METHODS: This case series and literature review serves to illustrate a relationship between spontaneous carotid occlusion and rapid enlargement of cerebral aneurysms. RESULTS: In our case series, we demonstrated that increased hemodynamic stress on collateral vessels caused by a spontaneous carotid occlusion may contribute to unusually rapid aneurysm growth and/or rupture. CONCLUSION: Spontaneous carotid occlusive disease may be considered a risk factor for rapid cerebral aneurysm progression and/or rupture that may warrant more aggressive management options, including more frequent surveillance imaging in previously treated aneurysms.
Aneurysm ; Carotid Artery, Internal* ; Female ; Hemodynamics ; Humans ; Intracranial Aneurysm* ; Natural History ; Risk Factors ; Rupture ; Smoking

OBJECTIVE: Due to longer life spans, patients newly diagnosed with unruptured intracranial aneurysms (UIAs) are increasing in number. This study aimed to evaluate how management of UIAs in patients age 65 years and older affects the clinical outcomes and post-procedural morbidity rates in these patients. METHODS: We retrospectively reviewed 109 patients harboring 136 aneurysms across 12 years, between 1997 and 2009, at our institute. We obtained the following data from all patients : age, sex, location and size of the aneurysm(s), presence of symptoms, risk factors for stroke, treatment modality, and postoperative 1-year morbidity and mortality. We classified these patients into three groups : Group A (surgical clipping), Group B (coil embolization), and Group C (observation only). RESULTS: Among the 109 patients, 56 (51.4%) underwent clipping treatment, 25 (23%) patients were treated with coiling, and 28 observation only. The overall morbidity and mortality rates were 2.46% and 0%, respectively. The morbidity rate was 1.78% for clipping and 4% for coiling. Factors such as hypertension, diabetes mellitus, hypercholesterolemia, smoking, and family history of stroke were correlated with unfavorable outcomes. Two in the observation group refused follow-up and died of intracranial ruptured aneurysms. The observation group had a 7% mortality rate. CONCLUSION: Our results show acceptable favorable outcome of treatment-related morbidity comparing with the natural history of unruptured cerebral aneurysm. Surgical clipping did not lead to inferior outcomes in our study, although coil embolization is generally more popular for treating elderly patients. In the treatment of patients more than 65 years old, age is not the limiting factor.
Aged ; Aneurysm ; Aneurysm, Ruptured ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Hypercholesterolemia ; Hypertension ; Intracranial Aneurysm ; Natural History ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Surgical Instruments

Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.
Humans ; Intervertebral Disc Degeneration ; Natural History ; Pathology* ; Reoperation ; Risk Factors ; Smoke ; Smoking ; Spinal Fusion ; Spine ; Sports ; Standard of Care ; Total Disc Replacement ; Viperidae

OBJECTIVE: In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. METHODS: In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questions given to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the two groups were compared to calculate the prenatal environmental risk factors of each group. RESULTS: Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio (AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. CONCLUSION: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.
Chungcheongnam-do* ; Environmental Exposure ; Female ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Korea ; Maternal Exposure ; Mothers* ; Odds Ratio ; Pregnancy ; Reproductive History ; Risk Factors* ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND/AIMS: This study was performed to evaluate the relationship between family history of gastrointestinal (GI) cancers and incidence of any GI cancer in the Korean population. METHODS: Between January 2015 and July 2016, 711 GI cancer patients and 849 controls in 16 hospitals in Korea were enrolled. Personal medical histories, life styles, and family history of GI cancers were collected via questionnaire. RESULTS: There was a significant difference in the incidence of family history of GI cancer between GI cancer patients and controls (p=0.002). Patients with family history of GI cancer tended to be diagnosed as GI cancer at younger age than those without family history (p=0.016). The family members of GI cancer patients who were diagnosed before 50 years of age were more frequently diagnosed as GI cancer before the age of 50 years (p=0.017). After adjusting for major confounding factors, age (adjusted odds ratio [AOR] 1.065, 95% confidence interval [CI]; 1.053–1.076), male gender (AOR 2.270, 95% CI; 1.618–3.184), smoking (AOR 1.570, 95% CI; 1.130–2.182), and sibling's history of GI cancer (AOR 1.973, 95% CI; 1.246–3.126) remained independently associated with GI cancers. CONCLUSIONS: GI cancer patients tended to have a first relative with a history of concordant GI cancer. Personal factors (old age and male) and lifestyle (smoking) contribute to the development of GI cancer, independently. Individuals with high risk for GI cancers may be advised to undergo screening at an earlier age.
Age Factors ; Gastrointestinal Neoplasms* ; Humans ; Incidence ; Korea ; Life Style ; Male ; Mass Screening ; Medical History Taking ; Odds Ratio ; Risk Factors ; Smoke ; Smoking

BACKGROUND: The purpose of this study was to determine the associations of the potential risk factors including reproductive history and lifestyle factors with bone mineral density at postmenopause. METHODS: The bone mineral density of the lumbar spine and proximal femur were measured by dual energy X-ray absorptiometry (DEXA), and physical and anthropometric data were obtained in 187 healthy postmenopausal women aged 45 to 73. Informations about risk factors were assessed by questionairres including medicosurgical and family history, reproductive history and lifestyle factors (dietary calcium intake, past use of oral contraceptives, consumption of alcohol and caffeine, smoking habits and exercise pattern). RESULTS: 1) Each prevalence of osteopenia and osteoporosis was 43.9% and 16.6% in postmenopausal women. 2) In simple correlation analysis between each risk factor and bone mineral density, factors associated with higher level in body mineral density (BMD) were body mass index (BMI)(p<0.01) and reproductive periods (p<0.05) in lumar spine and femur neck, and exerecise strength in femur neck (p<0.05). On the other hand, more aging and longer postmnopausal periods, lower BMD in lumbar spine and femur (p<0.01) and later menarche, lower BMD in lumbar spine (p<0.01) and femur neck (p<0.05) and higher frequencies of parity were influenced on lower BMD in lumbar spine and femur wards (p<0.01) and femur neck (p<0.05). But the other factors had no relation to BMD. 3) There was no significant difference in BMD according to the amount of diet calcium intake, gravity, lactation, the past use of oral contraceptives, the family history of osteoporosis, smoking habits and intake of caffeine and alcohol. 4) No reproductive history and other risk factors were significantly associated with BMD after the influences of age, postmenopausal periods and BMI were adjusted in multiple regression analysis. CONCLUSION: These results show there are no consistent effects on bone mineral density, after adjusting for age and BMI, of reproductive history and any other risk factors in postmenopausal women.
Absorptiometry, Photon ; Aging ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Caffeine ; Calcium ; Contraceptives, Oral ; Diet ; Female ; Femur ; Femur Neck ; Gravitation ; Hand ; Humans ; Lactation ; Life Style ; Menarche ; Osteoporosis ; Parity ; Postmenopause* ; Prevalence ; Reproduction ; Reproductive History ; Risk Factors* ; Smoke ; Smoking ; Spine

BACKGROUND: Breast cancer is the one of the commonly diagnosed female cancer in Korea. Numerous factors have been noted to be associated with risk of breast cancer: body mass index, menarche, menopause, family history, pregnancy and delivery, breastfeeding, alcohol use, smoking habits, diet, education and use of oral contraceptives. Little is known about hair minerals in breast cancer patient and about correlation between hair minerals and body mass index. METHODS: We compared hair mineral analysis data of 37 breast cancer subject with age and body mass index-matched normal control data (N = 144) by cross-sectional analysis. All breast cancer patients were newly diagnosed at one Breast Cancer Center in Ajou University and had their hair cut before anti-cancer chemotherapy, and the normal controls (without breast cancer) also had their hair cut for various reasons in out-patient clinics of the Department of Family Practice and Community Health. RESULTS: Breast cancer patients had low calcium, magnesium, and zinc, whereas they had high arsenic, sodium, and potassium compared with the normal controls. Only hair zinc level had significant negative correlation with body mass index (r = -0.705, P < 0.001) in breast cancer patients, not in normal controls. CONCLUSION: We observed the difference of hair mineral patterns in newly diagnosed breast cancer patients compared to normal controls and the correlation between these minerals and body mass index in breast cancer patient. Especially hair zinc concentration was significantly reduced and had significant negative correlation with body mass index in breast cancer patients.
Arsenic ; Body Mass Index ; Breast ; Breast Feeding ; Breast Neoplasms ; Calcium ; Contraceptives, Oral ; Cross-Sectional Studies ; Family Practice ; Female ; Food Habits ; Hair ; Humans ; Korea ; Magnesium ; Menarche ; Menopause ; Minerals ; Outpatients ; Potassium ; Reproductive History ; Smoke ; Smoking ; Sodium ; Zinc

BACKGROUND: Although there were studies about ethnic differences in aortic valve thickness and calcification that they may play a role in aortic valvular stenosis (AVS) progression, few studies about the progression rate of AVS in Asian population have been reported. The purpose of this study was to evaluate the progression rate of AVS in Korean patients. METHODS: We retrospectively analyzed 325 patients (181 men, age: 67 +/- 13 years) with AVS who had 2 or more echocardiograms at least 6 months apart from 2003 to 2008. The patients with other significant valvular diseases or history of cardiac surgery were excluded. The progression rate of AVS was expressed in terms of increase in maximum aortic jet velocity per year (meter/second/year). RESULTS: Baseline AVS was mild in 207 (64%), moderate in 81 (25%), and severe in 37 (11%). There were no significant differences among the three groups in terms of age, gender, hypertension, smoking, and hypercholesterolemia. The mean progression rate was 0.12 +/- 0.23 m/s/yr and more rapid in severe AVS (0.28 +/- 0.36 m/s/yr) when compared to moderate (0.14 +/- 0.26 m/s/yr) and mild AVS (0.09 +/- 0.18 m/s/yr) (p < 0.001). The progression rate in bicuspid AVS was significantly higher than other AVS (0.23 +/- 0.35 vs. 0.11 +/- 0.20 m/s/yr, p = 0.002). By multivariate analysis, initial maximum aortic jet velocity (Beta = 0.175, p = 0.003), bicuspid aortic valve (Beta = 0.127, p = 0.029), and E velocity (Beta = -0.134, p = 0.018) were significantly associated with AVS progression. CONCLUSION: The progression rate of AVS in Korean patients is slower than that reported in Western population. Therefore, ethnic difference should be considered for the follow-up of the patients with AVS.
Aortic Valve ; Aortic Valve Stenosis ; Asian Continental Ancestry Group ; Bicuspid ; Constriction, Pathologic ; Disease Progression ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Hypercholesterolemia ; Hypertension ; Male ; Multivariate Analysis ; Natural History ; Retrospective Studies ; Smoke ; Smoking ; Thoracic Surgery

BACKGROUND/AIMS: The natural history of severe erosive reflux disease in Korea remains uncertain. We aimed to evaluate endoscopic follow-up results in subjects with severe reflux esophagitis under routine clinical care. MATERIALS AND METHODS: A total 61,891 subjects underwent an upper endoscopic examination in the health check-up program from January 2007 to December 2013. We reviewed medical charts of patients who had been diagnosed with severe reflux esophagitis. The severity of reflux esophagitis was determined by the Los Angeles (LA) classification system. Patients underwent at least one follow up endoscopy after diagnosis of severe reflux esophagitis. We classified the patients into two groups; regressed in severity and remained unchanged, according to follow up endoscopic status. RESULTS: Based on endoscopic findings, 5,938 subjects (9.6%) were found to have reflux esopohagitis: 121 subjects (0.2%) in LA-C; 39 subjects (0.06%) in LA-D. Among 31 patients who had endoscopic follow-up, 23 patients (74.2%) showed regression from LA C/D to LA A/B or minimal change disease or normal. The mean follow up duration was 42.2 months in regression group and 53.2 months in no change group. All patients had been treated with proton pump inhibitors (PPIs) on a regular or on-demand basis. Age, sex, smoking, alcohol, exercise, hypertension, diabetes mellitus, dyslipidemia, sliding hiatal hernia, body mass index, waist circumference and duration of PPIs therapy did not significantly influence regression of severe reflux esophagitis. CONCLUSIONS: The majority of severe reflux esophagitis patients under routine clinical care showed improvement on endoscopic follow-up.
Body Mass Index ; Classification ; Diabetes Mellitus ; Diagnosis ; Dyslipidemias ; Endoscopy* ; Esophagitis ; Esophagitis, Peptic* ; Follow-Up Studies* ; Gastroesophageal Reflux ; Hernia, Hiatal ; Humans ; Hypertension ; Korea* ; Natural History ; Nephrosis, Lipoid ; Proton Pump Inhibitors ; Smoke ; Smoking ; Waist Circumference