BACKGROUND: Cardiovascular disease is the major cause of death in industrialized countries including Korea. METHODS: The methodology of cardiovascular disease clinical trials, published in 'The Korean Circulation Journal(KCJ)' and in 'The Korean Journal of Internal Medicine (KJIM)' from 1971 to 1993 were reviewed. For the study period, a total of 169 research papers in this field, includion 155 papers in the KCJ and 14 in the KJIM, were reviewed. To review the methodology behind the cardiovascular disease clinical trials, presence of a control group, set up a primary end point, determined sample size and the statistical method to be used, report on the side effects, and consent of patients were checked. In cases involving clinical trials using control groups, rendomization and blinding were also analysed. RESULTS: Among clinical trials reviewed only 6 (4.0%) of the 169 papers were used a control group, and 46.7% were set up with a primary end point. There was no clinical trial which used statitical methods to estimate the sample size. Clinical trials which reported results with statistical methods were 107 to 169 papers;most of these used the student's paired t-test. The number reporting the side effects of intervention was 143(88.7%) and papers reporting with the consent of patients was 15(8.8%). CONCLUSION: Most of clinical trials reviewed did not use appropriate method for clinical trials. Methodologically well-designed clinical trials in cardiovascular disease should be performed to guarantee the validity of study result.
Cardiovascular Diseases* ; Cause of Death ; Developed Countries ; Humans ; Internal Medicine ; Korea* ; Sample Size

PURPOSE: The purpose of this study was to estimate the heritability for cardiovascular disease(CVD) risk factors such as obesity, serum lipids, blood pressure and putative other risk factors. METHODS: Familial correlations and heritability in CVD risk factors were investigated with use of data from a community-based sample of 435 families involving 2,507 persons collected in the 1998 Korean Nationwide Nutrition and Health Examination Survey over the period November to December in 1998. The risk factors considered were obesity indexes such as waist circumference(WC), hip circumference(HC), waist-to-hip ratio(WHR), body mass index(BMI), serum lipids(total cholesterol, LDL- and HDL- cholesterol and triglyceride), systolic and diastolic blood pressure(SBP and DBP) and other putative risk factors(fasting blood sugar, creatinine, platelet, blood urea nitrate). RESULTS: First, the estimated heritabilites for obesity variables were 49.5% for WC, 46.6% for BMI, 43.2% for WHR and 39.2% for HC. Second, the estimated heritabilites for well-established CVD risk factors were 53% for LDL-cholesterol, 52% for total cholesterol, 52% for HDL-cholesterol, 24% for triglyceride, 39% for SBP and 30% for DBP. Third, the estimated heritabilites for the putative CVD risk factors were 39% for platelet, 39% for fasting blood sugar, 34% for blood urea nitrate, and 32% for creatinine level. CONCLUSION: Future linkage studies in these families may be worthwhile to further clarify the molecular basis for biological mechanisms controlling these CVD risk factors showing high heritability.
Blood Glucose ; Blood Platelets ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Creatinine ; Fasting ; Hip ; Humans ; Korea* ; Obesity ; Risk Factors* ; Triglycerides ; Urea

The effect of self rated health on all cause mortality was. examined in a community residents sample of 2, 848 men and 3, 534 women aged 55 years or over who has been followed for eight years, 1985-1993. This longitudinal study, conducted in Kangwha County, Keanggido, began in 1985 with baseline examinations of physical and life style characteristics. The results indicate that the self-rated health has a profound and independent effect on all cause mortality during the study period. Cox's hazard model estimates that persons with 'poor' self-rated health has 1.7 times (CI 1.2-2. 6) higher risk of all cause mortality than persons with 'excellent' self-rated health and persons with 'worst' one has 4.2 (CI 2.6-6.2) in male. Estimates for women are similar to those of men. Further researchs to investigate the effects on cause specfic mortality and effects to reveal the work mechanism of self-rated health are highly expected.
Aged* ; Cohort Studies* ; Female ; Follow-Up Studies* ; Humans ; Life Style ; Longitudinal Studies ; Male ; Mortality* ; Proportional Hazards Models

No abstract available.
Education* ; Humans ; Male*

BACKGROUND: It is well-known that a decline in the prevalence of smoking among physicians has preceded a decline in the general population. For the purpose of finding out the reason for lower smoking rate in Korean medical doctors than that of general population whether it is due to knowledge of toxicity related to smoking perceived as health professionals or as the only leader group in society this study was investigated. We selected lawyers as a representative of other professional groups. We investigated smoking rate, habits and attitudes towards smoking in Korean lawyers and compared the smoking rate and attitudes to wards smoking in lawyers with those of medical doctors. METHODS: This study investigates smoking rate, habits and attitudes towards smoking in Korean lawyers. An anonymous self-administered postal survey was used. One-third of registered lawyers were sampled according to stratified random sampling. Among 1,401 target population, 463 (38.3%) responded. RESULTS: Among male lawyers, 38.0% were current smokers, 38.9% were ex-smokers and 23.1% were non-smokers, while 7.7% were ex-smokers and 92.3% were non-smokers among female lawyers. The direct age-adjusted smoking rate among Korean male lawyers was 42.1%. CONCLUSION: In comparison of the direct age-adjusted smoking rate among male lawyers, medical doctors and general population in Korea, the rate in lawyers was 42.1%, medical doctors 34.9%, and general population 67.6%. The smoking rate of lawyers was found to be higher than that of medical doctors, but considerably lower than that of general population. In comparison of the attitudes towards smoking between lawyers and medical doctors, the lawyers were found to have a lower level of support in questions of the knowledge about the harmful effects of smoking and smoking bans on health than medical doctors.
Anonyms and Pseudonyms ; Female ; Health Occupations ; Health Services Needs and Demand ; Humans ; Korea* ; Lawyers* ; Male ; Prevalence ; Smoke* ; Smoking*

BACKGROUND: Previous reports have suggested that alleles at the plasminogen activator inhibitor-1 (PAI-1) gene are associated with increased risk of developing coronary artery disease, including myocardial infarction and stroke through their effect on PAI-1 levels. Method: We attempted to search English literatures for all reports of possible effects of PAI-1 gene on cardiovascular disease in human published prior to November 1998. We used a Mantel-Haenszel method (fixed effect model) and random effect model, respectively, to perform a meta-analysis of 7 case-control studies that provided information related to the effects of PAI-1 gene on risk of cardiovascular disease. RESULTS: From 7 studies for diagnosed cardiovascular disease, the relative frequencies of the three genotypes among controls was (5G/5G) (homozygous normal), 24.5%; (4G/5G) (heterozygous), 48.2%, and (4G/4G) (homozygous for the mutant, 675 GGGG), 27.3%. These relative frequencies in cases were 21.7% for 5G/5G, 48.0% for 4G/5G, and 30.3% for 4G/4G. In fixed effect model, compared with those with genotype (5G/5G), the overall odds ratio (OR) for cardiovascular disease among those with (4G/5G) was 1.12 (95% CI, 0.93 to 1.34), and it was 1.20 (1.01 to 1.44) for the (4G/4G) genotype. For five studies with myocardial infarction as the outcome, the overall OR of myocardial infarction was 1.20 (0.99 to 1.47) for those with (4G/5G) and 1.24 (1.00, 1.54) for those with (4G/4G) genotypes, respectively. CONCLUSION: Our findings provide support for the weak association between PAI-1 gene and cardiovascular disease, in particular, myocardial infarction.
Alleles ; Cardiovascular Diseases* ; Case-Control Studies* ; Coronary Artery Disease ; Genotype ; Humans ; Myocardial Infarction ; Odds Ratio ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Polymorphism, Genetic* ; Stroke

No abstract available.
Reye Syndrome*

Thrombomodulin (TM) is thrombin receptor present on the luminal surface of endothelial cells. Because the thrombin-TM complex acts as an anticoagulant, the functional variants or deficiency of TM may lead to increment of thrombotic tendency. In this study, we screened the genetic variants of the TM gene in patients with myocardial infarction (MI) and analyzed the genotype to elucidate the effects of genetic variations of TM gene on the development of the MI. We screened a promoter region and coding sequence of the TM gene using single strand conformation polymorphism-heteroduplex analysis and identified three common genetic variants: those were TM G-33A, TM Ala455Val, and TM C1922T. The genotype frequencies were investigated in the patients with MI (n=234) and control subjects (n=291) by the method of allele-specific oligomer hybridization. The frequencies of mutant genotypes (TM -33A, TM 455Val, and TM 1922T) were higher in patient group compared to the control subjects in males while there were no significant differences in females. In the multiple logistic regression analysis, TM 455Val and TM 1922T alleles were independent risk factors for MI (OR[95% CI: 1.799[1.125-2.878] p=0.014 and 5.624[1.019-31.025], p=0.048, respectively) in males. However, the genetic variations were not independent risk factors for MI in females. There were significant linkage disequilibriums among three genetic variants. These linkage disequilibriums explain the similar effects of three genetic variants on the development of MI. To investigate the effect of the TM G-33A mutation on TM promoter activity, the two TM promoter constructs (pTM-355 and pTM-125, bearing TM -33G or TM -33A) containing of firefly luciferase gene were transfected into HepG2, BAE, and CHO cells. The promoter activities were higher in the promoter constructs with TM -33G compared to the constructs with TM -33A in pTM-355. These results suggest the possibility of the positive predisposing effect of TM -33A allele on MI in males. The functional study for TM Ala455Val and TM C1922T should be followed to elucidate the genotype effects of these mutations on the development of MI. In this study, we identified three genetic variants of TM gene and showed the significant associations between genetic variants and MI in males. These results proposed that TM gene is an attractive candidate for genetic risk factor for MI in Koreans.
Alleles ; Animals ; CHO Cells ; Clinical Coding ; Cricetinae ; Endothelial Cells ; Female ; Fireflies ; Genetic Variation ; Genotype ; Humans ; Linkage Disequilibrium ; Logistic Models ; Luciferases ; Male ; Myocardial Infarction* ; Phenobarbital ; Promoter Regions, Genetic ; Receptors, Thrombin ; Risk Factors* ; Thrombomodulin

OBJECTIVE: To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. METHODS: From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. RESULT AND CONCLUSION: Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).
Alcohol Drinking ; Birth Order ; Chronic Disease ; Cohort Studies* ; Education ; Female ; Humans ; Korea ; Menopause* ; Middle Aged ; Mortality ; Odds Ratio ; Proportional Hazards Models ; Smoke ; Smoking

PURPOSE: To verify the association between cigarette smoking and bladder cancer in the Korean population, as smoking is well known as a risk factor on bladder cancer. The risk of bladder cancer was compared among never-smokers, ex-smokers and current-smokers using a multivariate adjusted incidence rate and the mortality rate of bladder cancer of Koreans. MATERIALS AND METHODS: A total of 348,010 participants were enrolled in this prospective study between 1993 (to 1994) and 2002. All participants completed a self administered questionnaire on cancer risk factors, including smoking habit. Follow up for incident bladder cancer was established. We classified all participants into three categories: current-smoker, ex-smoker and never-smoker, on the basis of their smoking habits. We confirmed bladder cancer from the data of the Korea National Cancer Registry and National Health Insurance Corporation up to (December?) 2002. The multivariate adjusted incidence and the mortality due to bladder cancer were used for both genders for a statistical analysis using a Cox proportional hazards model. RESULTS: The incidence rate of bladder cancer per 100,000 persons in male never-smokers, ex-smokers and current-smokers were 27, 41 and 48, respectively, and the multivariate adjusted relative risks (RR) were 1.3 (95% confidence interval (CI), 0.9-2.0) and 1.7 (95% CI, 1.2-2.3) in ex- and current smokers, respectively. The incidence rate of bladder cancer in women was 4.7, 8.4 and 13, respectively. There was no significant association between the risk of bladder cancer and the amount and duration of smoking. CONCLUSIONS: We concluded that current smokers have an increased incidence and mortality rate of bladder cancer in both genders in the Korean population, but there was no significant difference in relation to the amount and duration of smoking.
Cohort Studies* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Male ; Mortality ; National Health Programs ; Proportional Hazards Models ; Prospective Studies* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking* ; Tobacco Products* ; Urinary Bladder Neoplasms* ; Urinary Bladder*