OBJECTIVES: This study was conducted to investigate the association between health risk factors and mortality in Juam cohort. METHODS: The subjects were 1,447 males and 1,889 females who had been followed up for 68.5 months to 1 January 2001. Whether they were alive or not was confirmed by the mortality data of the National Statistical Office. A total of 289 persons among them died during the follow-up period. The Cox's proportional hazard regression model was used for survival analysis. RESULTS: Age, type of medical insurance, self cognitive health level, habit of alcohol drinking, smoking, exercise and BMI level were included in Cox's proportional hazard model by gender. The hazard ratio of age was 1.07(95% CI: 1.05-1.10) in men, 1.09(95% CI: 1.06-1.12) in women. The hazard ratio of medical aid(lower socioeconomic state) was 1.43(95% CI 1.02-2.19) in women. The hazard ratios of current alcohol drinking and current smoking were respectively 1.69(95% CI: 1.01-2.98), 1.52(95% CI: 1.02-2.28) in women. The hazard ratio of underweight was 1.56(95% CI 1.08-2.47) in men. The hazard ratios of underweight, normoweight, overweight, and obesity were respectively 1.63(95% CI: 1.02-2.67), 1.0(referent), 0.62(95% CI: 0.32-1.63), 1.27(95% CI: 0.65-3.06), which supported the U-shaped relationship between body mass index and mortality among the men over 65. CONCLUSIONS: The health risk factors increasing mortality were age, underweight in male, age, lower socioeconomic state, current alcohol drinking, current smoking in female. To evaluate long-term association between health risk factors and mortality, further studies need to be carried out.
Alcohol Drinking ; Body Mass Index ; Cohort Studies* ; Female ; Follow-Up Studies ; Health Status ; Humans ; Insurance ; Male ; Mortality* ; Obesity ; Overweight ; Proportional Hazards Models ; Risk Factors* ; Smoke ; Smoking ; Thinness

OBJECTIVES: This study aimed to estimate the completeness of cancer registration with Capture-recapture method. METHODS: The study was conducted in the population based cancer registry of Kwangju, Korea, for which there are three main sources of notification: reports by Korean Central Cancer Registry, reports by pathology data, and the others reports by radiology data, death certificates, etc. The defined cases in three sources were matched by 13 digits Resident Register Number. To derive an estimates, log-linear models were applicated. RESULTS: Overall completeness was estimated to be around 93%. There was some variation with age(consistently high levels below age group 60-74 years, a minimum of 88.6% above 75 years). Among the most common cancer sites, estimates of completeness were highest for thyroid cancer(97.1%), while lower estimates of completeness were derived for stomach cancer(92.3%), liver cancer(92.6%). CONCLUSIONS: Careful application of Capture-recapture method may provide an alternative to traditional approaches for estimating the completeness of cancer registration in Kwangju city.
Death Certificates ; Gwangju ; Humans ; Korea ; Linear Models ; Liver ; Pathology ; Stomach ; Thyroid Gland

OBJECTIVES: This 3-year longitudinal study was conducted to evaluate the influence of self-rating health perception on health care utilization and all cause-death risk. METHODS: The hypothesis was tested using a community-based samples, among which subjects 3,414 were interviewed in 1995. Self-rating health perception was assessed by single-item question. Three components of health care utilization amount(number of visits, number of medications, yearly health care expenses) per year were measured using medical insurance data during 3-year follow-up period among subjects in district health care insurance. There were 123 deaths from all causes among 3,085 subjects interviewed. RESULTS: The results showed that those who had poor health perception revealed more increases in the amount of health care utilization than good health perception group (p<0.05). After adjusting for age and sex, the poor health perception group had higher death risk over 3 years than good health perception group(hazard ratio=1.88). but, after adjusting health care utility, supplementary, was not significant. CONCLUSION: These results suggest that self-rating health percep-tion was associated with difference in health care utilization and all cause-death risk.
Delivery of Health Care* ; Follow-Up Studies ; Insurance ; Longitudinal Studies

BACKGROUND: To investigate epidemiology of a specific strain, and evaluate correlation between Mycobacterium tuberculosis restriction fragment length polymorphism (RFLP) and antimicrobial susceptibility, we studied about Mycobacterium tuberculosis RFLP isolated from Taegu area. METHODS: From Oct. 1997 and Mar. 1999, we isolated 54 strains of M. tuberculosis from the patients visiting Catholic University of Taegu Hyosung, Taegu, Korea. We studied their drug susceptibility and analyzed the Pvu treated RFLP using digoxigenin labeled IS6110 probe. RESULTS: Fifty-three had more than 6 bands of RFLP and strains with 10 bands were predominant (15 strain). Cluster analysis reveals eleven distinct clusters showing 57.4% of clustered rate (31 strains from A to K) and 35 independent patterns showing 64.8% of the diversity rate at 70% similarity level. Cluster A was the largest group (7 strains) and the next was cluster B (5 strains). Most of the patients with cluster A lived in Taegu city (85.7%) and all of 2 cluster K patients lived in Euisung area. There was no correlation between RFLP pattern and antimicrobial susceptibility, but all two strains of cluster H were resistant to isoniazid. Strains of clustered were also prevalent in the people of middle class. CONCLUSIONS: Compared to the RFLP analysis in the developed countries, Korea disclosed lower rate of diversity and higher clustered patterns of M. tuberculosis. The clustered strains were also prevalent among the people of middle class.
Daegu* ; Developed Countries ; Digoxigenin ; Epidemiology ; Humans ; Isoniazid ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Restriction Fragment Length* ; Tuberculosis

The CT findings of pulmonary paragonimiasis are well known. However, the pathologic findings of nodular opacity have not been studied sufficiently. To clarify the nature of nodular opacity on CT in patient with paragominiasis, we reviewed CT scans of 9 patients retrospectively. Five of them were compared with pathologic findings of the resected specimen. Other four patients were confirmed by needle aspiration biopsy. CT scans showed nodular opacities of 5 to 30mm in diameter which were accompanied with perinodular air-space consolidations in all patients. The usual location of nodular opacities were peripheral zone of the lung. Correlation with pathologic findings demonstrated That the nodular opacity on CT scans corresponded to the parasitic granuloma with central ova and intracystic worm. The most frequent CT finding of pulmonary paragonimiasis was nodular opacities with perinodular airspace consolidations caused by parasitic granuloma or intracystic worm.
Biopsy, Needle ; Granuloma ; Humans ; Lung ; Needles ; Ovum ; Paragonimiasis ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: During the development of inflammatory responses, various cytokines including interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF), interleukin-1 (IL-1) which activate macrophages to synthesize nitric oxide (NO) and hemostatic cascades are secreted. However, effects of various factors involved in hemostasis on NO synthesis have been little known. In this report, we studied the effects of antithrombin III (AT-III) on NO synthesis by thioglycollate-elicited peritoneal macrophages of BALB/c mouse. METHODS: Macrophages were obtained from BALB/c mice injected with 3% thioglycollate and cultured with or without various reagents. Nitrite concentration was measured using a modification of Griess reaction. Immunoblot analysis for inducible nitric oxide synthase (iNOS), AT-III receptor binding study and assay of TNF secretion were performed. RESULTS: AT-III alone did not induce nitrite synthesis by macrophages. However, AT-III induced nitrite synthesis in the presence of IFN-gamma in a dose dependant manner. iNOS was also expressed in macrophages by the treatment with IFN-gamma/AT-III. Addition of 0.5mM NG-monomethyl-L-arginine markedly inhibited IFN-gamma/AT-III-induced nirtite synthesis. Treatment with 5microgram/mL polymyxin B, which inactivates LPS, did not inhibit IFN-gamma/AT- III-induced nitrite synthesis, excluding inadvertent endotoxin contamination. Addition of rabbit anti-human AT-III polyclonal IgG antibodies, but not control rabbit IgG, inhibited IFN-gamma/ AT-III-induced nitrite production. Treatment of macrophages with heparin did not augment, but inhibited both IFN-gamma/AT-III- and IFN-gamma/LPS-induced nitrite synthesis. CONCLUSION: Our results indicated that AT-III acted as a modulator of macrophage activation for L-arginine dependent NO synthesis and that AT-III might be an important molecule in the regulation of immune responses by macrophage activation to induce NO synthesis as well as in the regulation of hemostasis. Heparin was not a cofactor in the AT-III-induced NO synthesis.
Animals ; Antibodies ; Antithrombin III* ; Arginine ; Cytokines ; Hemostasis ; Heparin ; Immunoglobulin G ; Indicators and Reagents ; Interferon-gamma ; Interleukin-1 ; Macrophage Activation ; Macrophages ; Macrophages, Peritoneal* ; Mice ; Nitric Oxide Synthase Type II ; Nitric Oxide* ; omega-N-Methylarginine ; Polymyxin B ; Tumor Necrosis Factor-alpha

PURPOSE: Although primary immunodeficiency disorders are relatively rare, early diagnosis provides the opportunity to reduce morbidity and mortality. The aim of this study was to investigate disease distribution, clinical manifestations, genetic mutation, treatment and prognosis of primary immunodeficiency disorders of childhood. METHODS: We retrospectively reviewed the medical records of 15 cases with primary immunodeficiency disorders between 1996 and 2004 in Samsung Seoul Hospital, Seoul, Korea. RESULTS: The most common primary immunodeficiency was common variable immunodeficiency (CVID) (n=7), followed by X-linked agammaglobulinemia (XLA) (n=3), severe combined immunodeficiency (SCID) (n=2), hyper IgM syndrome (n=1), selective IgA deficiency (n=1), and chronic granulomatous disease (CGD) (n=1). Most cases had recurrent infections such as otitis media, bacterial pneumonia, sinusitis and other respiratory infections during infancy. The age at diagnosis ranged from 4 months to 17 years with a median age of 5 years. The male to female ratio was 11 to 4. Eleven patients were diagnosed with primary immunodeficiency diseases following respiratory infection, while the other 4 patients had pulmonary tuberculosis, perianal abscess, bacterial meningitis, septic arthritis. All the patients with XLA and CVID were regularly treated with IVIG. Two cases of SCID underwent successful bone marrow transplantation without complications. The patients with hyper IgM syndrome died due to severe infection even after bone marrow transplantation. CONCLUSION: Fifteen variable cases of primary immunodeficiency were diagnosed during 9 years. A high index of suspicion is required in children with recurrent or severe infections for the diagnosis of primary immunodeficiency, because early diagnosis and treatment can reduce mortality and morbidity.
Abscess ; Agammaglobulinemia ; Arthritis, Infectious ; Bone Marrow Transplantation ; Child ; Common Variable Immunodeficiency ; Diagnosis ; Early Diagnosis ; Female ; Granulomatous Disease, Chronic ; Hospital Distribution Systems ; Humans ; Hyper-IgM Immunodeficiency Syndrome ; IgA Deficiency ; Immunoglobulins, Intravenous ; Korea ; Male ; Medical Records ; Meningitis, Bacterial ; Mortality ; Otitis Media ; Pneumonia, Bacterial ; Prognosis ; Respiratory Tract Infections ; Retrospective Studies ; Seoul* ; Severe Combined Immunodeficiency ; Sinusitis ; Tuberculosis, Pulmonary

BACKGROUND: Measuring urine albumin in diabetic patients is an important screening test to identify those individuals at high risk for cardiovascular disease and the progression of kidney disease. Recently, spot urine albumin-to-creatinine ratio (ACR) has replaced 24 hour-collected urine albumin excretion rate (AER) as a screening test for microalbuminuria given its comparative simplicity. The purpose of the current study was to evaluate the degree of correlation between AER and ACR in the normal, microalbuminuric and macroalbuminuric ranges, and to identify the lower limits of ACR for both genders. METHODS: A total of 310 type 2 diabetics admitted to one center were enrolled in the present study. Following the collection of a spot urine sample, urine was collected for 24 hours and albumin content was measured in both specimens. RESULTS: Mean patient age was 60.2 years. A total of 25.4% had microalbuminuria and 15.8% had macroalbuminuria. The data revealed a strongly positive correlation between AER and ACR across all ranges of albuminuria (R = 0.8). The cut-off value of ACR for 30 mg/day of AER by the regression equation was 24 microgram/mg for men, 42 microgram/mg for women and 31.2 microgram/mg for all patients. The diagnostic performance expressed as the area under the curve (AUC) was 0.938 (95% CI, 0.911-0.965) for ACR. ACR revealed a sensitivity of 84% and specificity of 84%, when a cut-off value of 31.2 microgram/mg was employed. CONCLUSION: ACR was highly correlated with AER, particularly in the range of microalbuminuria. The gender combined cut-off value of ACR in type 2 diabetic patients was determined to be 31.2 microg/mg However, additional studies of large outpatient populations, as opposed to the inpatient population used in the present study, are required to confirm the utility of this value.
Albuminuria ; Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Female ; Humans ; Inpatients ; Kidney Diseases ; Male ; Mass Screening ; Outpatients ; Sensitivity and Specificity

PURPOSE: The adenoma detection rate is commonly used as a measure of the quality of colonoscopy. This study assessed both the association between the adenoma detection rate and the quality of bowel preparation and the risk factors associated with the adenoma detection rate in screening colonoscopy. METHODS: This retrospective analysis involved 1,079 individuals who underwent screening colonoscopy at the National Cancer Center between December 2012 and April 2014. Bowel preparation was classified by using the Aronchick scale. Individuals with inadequate bowel preparations (n = 47, 4.4%) were excluded because additional bowel preparation was needed. The results of 1,032 colonoscopies were included in the analysis. RESULTS: The subjects' mean age was 53.1 years, and 657 subjects (63.7%) were men. The mean cecal intubation time was 6.7 minutes, and the mean withdrawal time was 8.7 minutes. The adenoma and polyp detection rates were 28.1% and 41.8%, respectively. The polyp, adenoma, and advanced adenoma detection rates did not correlate with the quality of bowel preparation. The multivariate analysis showed age ≥ 60 years (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.02–1.97; P = 0.040), body mass index ≥ 25 kg/m² (HR, 1.56; 95% CI, 1.17–2.08; P = 0.002) and current smoking (HR, 1.44; 95% CI, 1.01–2.06; P = 0.014) to be independent risk factors for adenoma detection. CONCLUSION: The adenoma detection rate was unrelated to the quality of bowel preparation for screening colonoscopy. Older age, obesity, and smoking were independent risk factors for adenoma detection.
Adenoma* ; Body Mass Index ; Colonoscopy* ; Humans ; Intubation ; Male ; Mass Screening* ; Multivariate Analysis ; Obesity ; Polyps ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking

No abstract available.
Child* ; Humans ; Korea* ; Myocarditis* ; Rheumatic Fever*