1.Conceptualized framework for levels of obstetric care.
Obstetrics & Gynecology Science 2018;61(3):289-297
It has been demonstrated that risk-appropriate perinatal and obstetric care can improve perinatal morbidity and mortality. Recently, various studies focus on the importance of evaluation for maternal conditions and allocation of high risk pregnant women to highly qualified facilities. Therefore, it is necessary to develop the conceptualized framework for levels of obstetric care and establish the guidelines for the situations that should be cared in each level of facility. In this review article, we reviewed several classifications of obstetric care in eastern and western countries, and conditions in which transfer should be recommended depending on the risk and capacity of centers.
Classification
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Female
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Humans
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Mortality
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Pregnancy, High-Risk
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Pregnant Women
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Referral and Consultation
2.A Case of EDTA Dependent Platelet Phagocytosis by Neutrophils in Mycosis Fungoides.
Gyoung Yim HA ; Moon Yeon KIM ; Jung Ran KIM ; Moo Ku SUH ; So Young KWEON ; Han Ik CHO
Korean Journal of Clinical Pathology 1998;18(1):46-50
In vitro ethylene-diamine-tetra-acetic acid (EDTA) dependent satellitism and phagocytosis of platelets by neutrophils have been considered to be rare phenomena. It is associated with pseudothrombocytopenia, abnormal histogram of platelets and pseudoleukocytosis on complete blood cell count (CBC) by automated blood cell counter, but these findings are not found in heparinized or sodium citrated blood. It has no clinical significance such as bleeding tendency or abnormal platelet function. EDTA dependent platelet satellitosis and phagocytosis must be differentiated from true thrombocytopenia. We report a case of EDTA dependent platelet phagocytosis by neutrophils in a 68 year-old male patient who was diagnosed as mycosis fungoides. His EDTA blood smear showed frequent phagocytosis of platelets by neutrophils and occasional platelet satellitism. The bood cell counts were within normal limits without pseudothrombocytopenia. Phagocytized platelets were confirmed by immunohistochemistry using GpIIb/IIIa antibody and transmission electron micrographs.
Aged
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Blood Cell Count
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Blood Platelets*
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Cell Count
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Edetic Acid*
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Hemorrhage
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Heparin
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Humans
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Immunohistochemistry
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Male
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Mycosis Fungoides*
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Neutrophils*
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Phagocytosis*
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Sodium
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Thrombocytopenia
3.The Relationship between Socioeconomic Status and Gastric Cancer Screening in the Population of a Metropolitan Area.
Hyun Suk OH ; Sun A KIM ; Sun Seog KWEON ; Jung Ae RHEE ; So Yeon RYU ; Min Ho SHIN
Journal of Agricultural Medicine & Community Health 2013;38(3):174-181
OBJECTIVES: Socioeconomic status plays an important role in health care and disease prevention. This study aimed to examine the association between socioeconomic status, measured by education levels and household income, and gastric cancer screening. METHODS: A total of 21,220 community-dwelling adults aged 40 to 69 years within a defined geographic area participated in a community health survey in 2009 and 2010. The survey was conducted using a structured questionnaire by trained investigators who visited the subjects' households directly. Logistic regression analysis was used to determine the relationship between self-reported participation in gastric cancer screening and socioeconomic variables (education and household income). RESULTS: The gastric cancer screening rate was 52.1% for subjects in their forties, 63.7% for those in their fifties, and 67.3% for those in their sixties. In multivariate analysis, higher education and income levels were associated with higher rates of gastric cancer screening (high school vs. elementary school: odds ratio [OR] 1.41, 95 % confidence interval [CI] 1.26-1.58; highest income quartile vs. lowest income quartile: OR 1.62, 95% CI 1.44-1.84). The gradient between income and screening rate was more pronounced in the population aged 40 to 49 years than in the other age groups. CONCLUSIONS: This study demonstrates that lower socioeconomic status is associated with decreased participation in gastric cancer screening. Our findings suggest that the screening program should be focused on low-income and less-educated populations, especially among younger adults, to reduce health disparities.
Adult
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Delivery of Health Care
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Education
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Family Characteristics
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Health Surveys
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Humans
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Logistic Models
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Mass Screening*
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Multivariate Analysis
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Odds Ratio
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Research Personnel
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Social Class*
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Stomach Neoplasms*
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Surveys and Questionnaires
4.Factors Associated with COVID-19 Vaccine Hesitancy in Korea
Sun-Seog KWEON ; Il YUN ; Changkyun CHOI ; So-Yeon RYU ; Jun Hwi CHO ; Min-Ho SHIN
Chonnam Medical Journal 2022;58(1):43-47
COVID-19 vaccine hesitancy will likely increase in the unvaccinated general population because of several vaccine safety issues that arose during priority vaccination.To investigate the potential rate of COVID-19 vaccine hesitancy in the unvaccinated population and evaluate factors that affect the attitude towards vaccine acceptance, a cross-sectional survey was performed. A telephone survey was conducted in 1,357 people older than 18 years; 99 were excluded from the analysis because they had already been vaccinated (n=58) or hesitated (n=41) after an official call. The COVID-19 vaccine hesitancy rate was 21.9% and was highest among those aged under 30 years (33.4%) and lowest among those aged 65 years and over (8.7%). Age, occupation, and perceived confidence in vaccine safety and efficacy were associated with vaccine hesitancy. These findings suggest that public health authorities should strengthen the spread of correct information, especially in the younger population, to increase vaccination rates.
5.Factors related to femoral bowing among Korean female farmers:a cross-sectional study
Sangyoon DO ; Chul Gab LEE ; Dong Hwi KIM ; GwangChul LEE ; Kweon Young KIM ; So Yeon RYU ; Hansoo SONG
Annals of Occupational and Environmental Medicine 2020;32(1):e23-
Background:
Female farmers have a high prevalence of knee osteoarthritis (KOA) in South Korea. Femoral bowing has been reported to be related to KOA by increasing load on the mechanical axis. This study aimed to investigate factors related to femoral bowing in Korean female farmers.
Methods:
We analyzed the legs of 264 female farmers registered with the Korea farmers' knee cohort of Jeonnam Center for Farmers' Safety and Health. A structured questionnaire was used to determine sociodemographic variables, agricultural career, cumulative squatting working time (CSWT), and cumulative heavy lifting working time. Femoral bone density was measured and Kellgren-Lawrence (KL) grades were obtained from the knee radiographs.Mechanical axis angle (MAA), femoral bowing angle (FBA), anatomical lateral distal femoral angle (aLDFA), anatomical medial proximal tibial angle (aMPTA), and condylar-plateau angle (CPA) were measured. We examined the relationship between the FBA and related factors by using multiple linear regression.
Results:
The proportion of individuals with radiographic KOA (≥ KL grade 2) in this study was 37.9%. As KL grades increased, MAA, FBA, and CPA increased, whereas aLDFA and aMPTA decreased. FBA increased with age. Multiple linear regression analyses using FBA as a dependent variable showed relationship with higher age, lower height, higher BMI, lower bone mineral density, longer CSWT, and longer agricultural careers.
Conclusions
The results of this study suggest that external factors related to agricultural work in female farmers was associated with femoral bowing, in addition to internal factors such as age, bone density, height, and obesity.
6.Factors related to femoral bowing among Korean female farmers:a cross-sectional study
Sangyoon DO ; Chul Gab LEE ; Dong Hwi KIM ; GwangChul LEE ; Kweon Young KIM ; So Yeon RYU ; Hansoo SONG
Annals of Occupational and Environmental Medicine 2020;32(1):e23-
Background:
Female farmers have a high prevalence of knee osteoarthritis (KOA) in South Korea. Femoral bowing has been reported to be related to KOA by increasing load on the mechanical axis. This study aimed to investigate factors related to femoral bowing in Korean female farmers.
Methods:
We analyzed the legs of 264 female farmers registered with the Korea farmers' knee cohort of Jeonnam Center for Farmers' Safety and Health. A structured questionnaire was used to determine sociodemographic variables, agricultural career, cumulative squatting working time (CSWT), and cumulative heavy lifting working time. Femoral bone density was measured and Kellgren-Lawrence (KL) grades were obtained from the knee radiographs.Mechanical axis angle (MAA), femoral bowing angle (FBA), anatomical lateral distal femoral angle (aLDFA), anatomical medial proximal tibial angle (aMPTA), and condylar-plateau angle (CPA) were measured. We examined the relationship between the FBA and related factors by using multiple linear regression.
Results:
The proportion of individuals with radiographic KOA (≥ KL grade 2) in this study was 37.9%. As KL grades increased, MAA, FBA, and CPA increased, whereas aLDFA and aMPTA decreased. FBA increased with age. Multiple linear regression analyses using FBA as a dependent variable showed relationship with higher age, lower height, higher BMI, lower bone mineral density, longer CSWT, and longer agricultural careers.
Conclusions
The results of this study suggest that external factors related to agricultural work in female farmers was associated with femoral bowing, in addition to internal factors such as age, bone density, height, and obesity.
7.Effect Modification of Kidney Function on the Non-linear Association Between Serum Calcium Levels and Cardiovascular Mortality in Korean Adults
Jung-Ho YANG ; Sun-Seog KWEON ; Young-Hoon LEE ; Seong-Woo CHOI ; So-Yeon RYU ; Hae-Sung NAM ; Hye-Yeon KIM ; Min-Ho SHIN
Journal of Preventive Medicine and Public Health 2023;56(3):282-290
Objectives:
This study aimed to evaluate the potential interaction between kidney function and the non-linear association between serum calcium levels and cardiovascular disease (CVD) mortality.
Methods:
This study included 8927 participants enrolled in the Dong-gu Study. Albumin-corrected calcium levels were used and categorized into 6 percentile categories: <2.5th, 2.5-25.0th, 25.0-50.0th, 50.0-75.0th, 75.0-97.5th, and >97.5th. Restricted cubic spline analysis was used to examine the non-linear association between calcium levels and CVD mortality. Cox proportional hazard regression was used to estimate hazard ratios (HRs) for CVD mortality according to serum calcium categories. All survival analyses were stratified by the estimated glomerular filtration rate.
Results:
Over a follow-up period of 11.9±2.8 years, 1757 participants died, of whom 219 died from CVD. A U-shaped association between serum calcium and CVD mortality was found, and the association was more evident in the low kidney function group. Compared to the 25.0-50.0th percentile group for serum calcium levels, both low and high serum calcium tended to be associated with CVD mortality (<2.5th: HR, 6.23; 95% confidence interval [CI], 1.16 to 33.56; >97.5th: HR, 2.56; 95% CI, 0.76 to 8.66) in the low kidney function group. In the normal kidney function group, a similar association was found between serum calcium levels and CVD mortality (<2.5th: HR, 1.37; 95% CI, 0.58 to 3.27; >97.5th: HR, 1.65; 95% CI, 0.70 to 3.93).
Conclusions
We found a non-linear association between serum calcium levels and CVD mortality, suggesting that calcium dyshomeostasis may contribute to CVD mortality, and kidney function may modify the association.
8.The Association between the Apolipoprotein E Gene Polymorphism and All-cause Mortality in the Korean Population
Chang Kyun CHOI ; Sun Seog KWEON ; Young Hoon LEE ; Hae Sung NAM ; Kyeong Soo PARK ; So Yeon RYU ; Seong Woo CHOI ; Hye Yeon KIM ; Min Ho SHIN
Journal of Korean Medical Science 2019;34(40):e269-
BACKGROUND: Apolipoprotein E (APOE) gene polymorphism is associated with neurodegenerative and cardiovascular diseases. Although the effects of the gene differ by ethnic group, few studies have examined Asians. Therefore, the association between APOE polymorphism and mortality in Koreans was evaluated in this study. METHODS: This study population included participants from the Dong-gu and Namwon Studies. APOE genotypes were categorized as E2 (E2/E2 and E2/E3), E3 (E3/E3), and E4 (E3/E4 and E4/E4). Multivariate Cox proportional hazard models were constructed using the E3 allele as a reference. RESULTS: In the model adjusting for study site, age, gender, and lifestyle, the hazard ratio (HR) of mortality for those with the E4 allele was 1.08 (95% confidence interval [CI], 0.97–1.20), while that for those with the E2 allele was 0.84 (95% CI, 0.74–0.96). After adjusting for blood lipids to evaluate their mediating effects, the HRs of mortality for those with E4 and E2 alleles were 1.08 (95% CI, 0.97–1.20) and 0.80 (95% CI, 0.70–0.92), respectively. These associations were more evident in younger groups, with HRs of 0.70 (95% CI, 0.52–0.92) for the E2 allele and 1.25 (95% CI, 1.03–1.53) for the E4 allele. CONCLUSION: In two large population-based cohort studies, the E2 allele was associated with a lower risk of mortality compared with the E3 allele, whereas the E4 genotype was not associated with mortality in Koreans.
Alleles
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Apolipoproteins E
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Apolipoproteins
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Asian Continental Ancestry Group
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Cardiovascular Diseases
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Cohort Studies
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Ethnic Groups
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Genotype
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Humans
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Jeollabuk-do
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Life Style
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Mortality
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Negotiating
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Proportional Hazards Models
9.Effect Modification of Acetaldehyde Dehydrogenase 2 rs671 Polymorphism on the Association between Alcohol Intake and Blood Pressure: the Dong-gu Study
Hye Yeon KIM ; Chang Kyun CHOI ; Sun Seog KWEON ; Young Hoon LEE ; Hae Sung NAM ; Kyeong Soo PARK ; So Yeon RYU ; Seong Woo CHOI ; Min Ho SHIN
Journal of Korean Medical Science 2020;35(9):14-
BACKGROUND: Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 (ALDH2) polymorphism is common in Eastern Asians, and inactive ALDH2 genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the ALDH2 genotypes.METHODS: This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and ALDH2 genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed.RESULTS: In men, alcohol consumption was positively associated with both SBP and DBP in active ALDH2 carriers, but not in inactive ALDH2 carriers. In active ALDH2 carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91–1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15–1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between ALDH2 genotypes and hypertension and blood pressure in women.CONCLUSION: ALDH2 genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active ALDH2 carriers, but no significant relationship in inactive ALDH2 carriers.
Acetaldehyde
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Alcohol Drinking
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Aldehyde Dehydrogenase
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Asian Continental Ancestry Group
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Blood Pressure
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Cardiovascular Diseases
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Cohort Studies
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Female
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Genotype
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Humans
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Hypertension
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Linear Models
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Logistic Models
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Male
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Odds Ratio
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Oxidoreductases
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Risk Factors
10.Effect Modification of Acetaldehyde Dehydrogenase 2 rs671 Polymorphism on the Association between Alcohol Intake and Blood Pressure: the Dong-gu Study
Hye Yeon KIM ; Chang Kyun CHOI ; Sun Seog KWEON ; Young Hoon LEE ; Hae Sung NAM ; Kyeong Soo PARK ; So Yeon RYU ; Seong Woo CHOI ; Min Ho SHIN
Journal of Korean Medical Science 2020;35(9):e14-
BACKGROUND:
Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 (ALDH2) polymorphism is common in Eastern Asians, and inactive ALDH2 genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the ALDH2 genotypes.
METHODS:
This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and ALDH2 genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed.
RESULTS:
In men, alcohol consumption was positively associated with both SBP and DBP in active ALDH2 carriers, but not in inactive ALDH2 carriers. In active ALDH2 carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91–1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15–1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between ALDH2 genotypes and hypertension and blood pressure in women.
CONCLUSION
ALDH2 genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active ALDH2 carriers, but no significant relationship in inactive ALDH2 carriers.