1.The Combined Effects of Alcohol Consumption and Smoking on Cancer Risk by Exposure Level: A Systematic Review and Meta-Analysis
Seunghee JUN ; Hyunjin PARK ; Ui-Jeong KIM ; Hye Ah LEE ; Bomi PARK ; Soon Young LEE ; Sun Ha JEE ; Hyesook PARK
Journal of Korean Medical Science 2024;39(22):e185-
Background:
Alcohol consumption is a major risk factor for cancer, and when combined with smoking, the risk increases. Nevertheless, few studies have comprehensively evaluated the combined effects of alcohol consumption and smoking on the risk of various cancer types.Therefore, to assess these effects, we conducted a systematic review and meta-analysis.
Methods:
We performed a systematic search of five literature databases, focusing on cohort and case-control studies. Considering exposure levels, we quantified the combined effects of alcohol consumption and smoking on cancer risk and assessed multiplicative interaction effects.
Results:
Of 4,452 studies identified, 24 (4 cohort studies and 20 case-control studies) were included in the meta-analysis. We detected interaction effect of light alcohol and moderate smoking on head and neck cancer risk (relative risk [RR], 4.26; 95% confidence interval [CI], 2.50–7.26; I2 = 65%). A synergistic interaction was observed in heavy alcohol and heavy smoking group (RR, 35.24; 95% CI, 23.17–53.58; I2 = 69%). In more detailed cancer types, the interaction effect of heavy alcohol and heavy smoking was noticeable on oral (RR, 36.42; 95% CI, 24.62–53.87; I2 = 46%) and laryngeal (RR, 38.75; 95% CI, 19.25–78.01; I2 = 69%) cancer risk.
Conclusion
Our study provided a comprehensive summary of the combined effects of alcohol consumption and smoking on cancers. As their consumption increased, the synergy effect became more pronounced, and the synergy effect was evident especially for head and neck cancer. These findings provide additional evidence for the combined effect of alcohol and smoking in alcohol guidelines for cancer prevention.
2.Prognosis of subsequent pregnancy in uterine necrosis after uterine artery embolization
Kyung Eun LEE ; Seon Ui LEE ; Jun KANG ; Hyun Wook LIM ; In Yang PARK ; Min Jeong KIM
Obstetrics & Gynecology Science 2024;67(3):335-338
In an 8-year period at two medical center, 138 patients underwent uterine artery embolization, and 11 of them were diagnosed with uterine necrosis. Among them, three were successfully conceived. However, one of them developed an arteriovenous malformation after an artificial abortion, and another experienced complications, including placenta previa and placenta accreta spectrum, which resulted in early preterm delivery and recurrent postpartum hemorrhage, necessitating subtotal hysterectomy. Therefore, it is crucial to prepare for potential adverse pregnancy outcomes in subsequent pregnancies for patients with a history of uterine necrosis.
3.Diagnosis and treatment of adult spinal deformity
Kwang-Ui HONG ; Seung-Jae HYUN ; Jae-Koo LEE, ; Ki-Jeong KIM
Journal of the Korean Medical Association 2023;66(8):497-505
The diagnosis rate of adult spinal deformity (ASD) is increasing with increased life expectancy and the prevalence of degenerative spinal diseases. The prevalence of ASD in adults aged >60 years has been reported to be up to 68%. ASD has significant impact on the pain, disability, and mental health. Therefore, it is necessary to establish an effective surgical plan by accumulating modern knowledge on ASD, developing surgical techniques, and improving pre- and post-operative care so as to achieve optimal surgical outcomes.Current Concepts: ASD results from coronal and sagittal malalignments caused by degenerative diseases or iatrogenic factors. Recently, the significance of sagittal alignment correction has been emphasized, and the SRSSchwab classification of ASD is generally accepted. Individualized correction goals can be set through sufficient preoperative evaluations and imaging studies, and appropriate coronal and sagittal alignment correction can be achieved through intraoperative positioning of patient, anterior and posterior approach spine surgery, screw fixation, and osteotomies.Discussion and Conclusion: It is necessary to establish an optimal correction target and select the appropriate surgical approach for each patient with ASD, so as to improve patients’ quality of life. Surgical interventions for ASD can be safely completed by adequately comprehending and anticipating perioperative complications.
4.Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
Seunghee JUN ; Hyunjin PARK ; Ui-Jeong KIM ; Eun Jeong CHOI ; Hye Ah LEE ; Bomi PARK ; Soon Young LEE ; Sun Ha JEE ; Hyesook PARK
Epidemiology and Health 2023;45(1):e2023092-
OBJECTIVES:
Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis.
METHODS:
Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.
RESULTS:
Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males.
CONCLUSIONS
Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.
5.Health and Mortality in Korean Healthcare Workers
Yoonhee SHIN ; Ui Jeong KIM ; Hye Ah LEE ; Eun Jeong CHOI ; Hyun Jin PARK ; Hyeong Sik AHN ; Hyesook PARK ;
Journal of Korean Medical Science 2022;37(3):e22-
Background:
To evaluate the health status of healthcare workers (doctors and nurses) compared to those in the general population based on the National Health Insurance Service database and the cause of death data from Statistics Korea.
Methods:
The subjects of this study were 104,484 doctors and 220,310 nurses working in healthcare facilities from 2002 to 2017, and who had undergone at least one general medical examination. Based on the subject definition, the subject data were extracted from the National Health Insurance healthcare facility database and qualification database. We collected medical use details included in the research database, general medical examination results, medical history included in the health examination database, and additional data on the cause of death from the National Statistics database to analyze the main cause of death and mortality.
Results:
In terms of the major causes of death and mortality among healthcare workers, the mortality rate associated with intentional self-harm, injury, transportation accident, heart disease, addiction, and falling was significantly higher than that in the general population. Further, the prevalence of respiratory and gastrointestinal diseases was high. When analyzing the proportional mortality ratio (PMR) by cause of death for healthcare workers, the PMR values for death related to malignant neoplasm was the highest. In terms of diseases, both doctors and nurses had higher rates of infectious diseases such as maternal sepsis, rubella, and measles.
Conclusion
The health status of healthcare workers differs from that of the general population. Thus, it is important to consider the occupational characteristics of healthcare personnel. This study is unique in that it was conducted based on medical use indicators rather than survey data.
6.Joinpoint Regression About Injury Mortality and Hospitalization in Korea
Hyun Jin PARK ; Ui Jeong KIM ; Won kyung LEE ; Bohyun PARK ; Yoonhee SHIN ; Seonhwa LEE ; Eun Jeong CHOI ; Nam-eun KIM ; Ju Ok PARK ; Hyesook PARK
Journal of Korean Medical Science 2022;37(3):e10-
Background:
Injury is a social problem that causes health and property losses, and it is important to identify the size and trend of injury for efficient prevention and management.Therefore, this study analyzed the trends in injury mortality and hospitalization rates from 2005 to 2019 in Korea.
Methods:
Using mortality data by Statistics Korea and Korea National Hospital Discharge In-depth injury survey by the Korea Disease Control and Prevention Agency (KDCA), age standardized rates were calculated for death and hospitalization to analyze trends and annual changes with the joinpoint regression model. In addition, annual changes in the hospitalization rate of the transport accident and fall injuries by age group were analyzed, which are the major causes of injuries.
Results:
From 2005 to 2019, the injury mortality rate has been on the decline, but the injury hospitalization rate has been on the rise. The annual rate of change varied depending on the injury mechanism, but the mortality rate tended to decrease or remain similar level, while the rate of hospitalization has steadily increased. In addition, by age group, injury mortality and hospitalization rates were high in the elderly. In particular, the hospitalization rate of the elderly was higher when comparing the hospitalization rate of the children in transport accidents and falls. Pedestrian transport accidents tended to decrease under the age of 15, but remained similar for those aged 65 and older, and bicycle accidents tended to increase in both groups. In addition, hospitalization rates were higher in the fall, with both groups showing a statistically significant increase in hospitalization rates caused by falls.
Conclusion
This study analyzed the trend of injury mortality and hospitalization and found that transport accidents and falls may vary depending on the means or age of the accident.Since injury is a big social problem that is a burden of disease, safety education and legal sanctions for injury prevention should be further improved in the future, especially by prioritizing vulnerable groups by age and detailed mechanisms of injury.
7.Hydramnios related to fetal deformity in a Hanwoo cow: a case report
Jae Kwan JEONG ; Sanggu KIM ; Ui Hyung KIM ; Dongwoo CHANG ; Soochong KIM ; Ill Hwa KIM
Korean Journal of Veterinary Research 2022;62(4):e32-
A Hanwoo cow with a delayed gestation and abdominal distension was delivered following PGF2α injection. There was excessive amniotic fluid, and a male calf was delivered but died immediately. The calf had no eyes and nose, and a cleft palate on the upper jaw. Gross appearance and computed tomography image showed that upper teeth were spread out on both sides due to cleft palate in the upper jaw, and lower jaw and teeth were positioned upward. There were no other brain parts except cerebellum. These findings show a rare case of hydramnios related to fetal congenital deformity in a Hanwoo cow.
8.Disease burden and epidemiologic characteristics of injury in Korea
Seunghee JUN ; Hyunjin PARK ; Ui Jeong KIM ; Hyesook PARK
Journal of the Korean Medical Association 2022;65(10):649-654
Injury is a major public health concern because it is a major cause of death and may cause lifelong disabilities. New environmental risk factors, such as extreme climates, are now emerging, and the vulnerable elderly population is rapidly growing. Therefore, understanding the epidemiological characteristics and trends of injury is necessary to establish preventive policies and actions.Current Concepts: Injury accounts for 13.3% of the disease burden in Korea, which is higher than the global proportion (9.8%). In addition, in 2019, the life years lost due to injury in Korea was 973,030, which is also higher than in the other 37 countries of the Organisation for Economic Co-operation and Development (OECD). Mortality due to injury has shown a downward trend, while mortality due to falls has shown an upward trend since 2010. Mortality due to injury in Korea is higher than the OECD average, and mortality due to intentional self-harm was the highest. Intentional self-harm accounts for 50.8% of deaths due to injury. In hospitalization due to injury, falls account for the largest proportion (38.5%) and frequently occur in older adults.Discussion and Conclusion: Although the mortality rate of injury is decreasing, the magnitude of injury in Korea is still higher than the OECD average. We hope these findings are used as basic data to find a targeted approach for injury prevention.
9.Cohort profile: the Ewha Birth and Growth Study
Hye Ah LEE ; Bohyun PARK ; Jungwon MIN ; Eun Jeong CHOI ; Ui Jeong KIM ; Hyun Jin PARK ; Eun Ae PARK ; Su Jin CHO ; Hae Soon KIM ; Hwayoung LEE ; Young Ju KIM ; Young Sun HONG ; Eui-Jung KIM ; Eun Hee HA ; Hyesook PARK
Epidemiology and Health 2021;43(1):e2021016-
With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.
10.Cohort profile: the Ewha Birth and Growth Study
Hye Ah LEE ; Bohyun PARK ; Jungwon MIN ; Eun Jeong CHOI ; Ui Jeong KIM ; Hyun Jin PARK ; Eun Ae PARK ; Su Jin CHO ; Hae Soon KIM ; Hwayoung LEE ; Young Ju KIM ; Young Sun HONG ; Eui-Jung KIM ; Eun Hee HA ; Hyesook PARK
Epidemiology and Health 2021;43(1):e2021016-
With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.

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