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An epidemiologic review of Japanese Encephalitis with a special focus on incidence and methods of control for South Korea.
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Hee choul Ohrr, Sang Wook Lee, Jae Seok Hong
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Korean J Epidemiol. 2005;27(1):69-80.
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Japanese encephalitis(JE) is the leading viral cause of encephalitis and disability in Asia. The disease primarily infects children under the age of 15, leaving up to 70% of these who develop illness either dead or with a long-term neurological disability. We reviewed not only JE disease burden, etiology, vector, mode of transmission, reservoir but also geographic distribution and incidence of the disease in Asia, with a focus on the South Korea. A special comment on the methods of control JE and perspective for South Korea also included.
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A Study on the Relationship Between Smoking Habits and BMI of Adult Males.
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Joo Hee Han, Myung Kim, Dae Hyu Oh, Hee Choul Ohrr
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Korean J Epidemiol. 1998;20(1):39-50.
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Smoking, obesity and diet are just a few of the multifactors which have been suggested to be associated with the risk of CHD. It is a common phenomenon that persons who stop smokin gain weight. This fear of gaining weight is often given as a reason for giving up to quit smoking. The purpose of this study is to find the effects of cessation of smoking on body weight and the difference of BMI distribution according to smoking habits. The subjects of this study were 72 techinical high school teachers in Seoul and Kyounggi-Do, 85 offical wokers of the S-Company and 81 auto industrial workers in PyoungTaek. The investigation for this study has been conducted from Oct. 27th to Oct. 31st 1997. The method was self-feported questionnaire survey which consists of general characterisics, smoking habits and its relevant questions. The questionnaires were revised after two-times of pre-tests, carried out for twenty subjects. The results are as follows ; 1. Smoking habits have significant relations with diet, exercise, drinking and the amount of daily smoking. 2. BMI among different smoking habits groups showed significant differences in following variables ; age, the interaction between exercise and smoking habits, drinking level, the interaction etween drinking level and smoking habits and the interaction between total smoking duration and smoking gabits. 3. The mean values of BMI are 23.5 in non-smoker, 23.8 in ex-smoker and 23.4 in current smoker. There are no statistically significant differencs among amoking habits. 4. The average of 2.14kg weight gain is witnessed after 6 months of the cessation of smoking.
Current weight was high by 3.89kh in average compared to the pre-cessation weight(p=0.0001). 5. The odds ratio for gaining weight among ex-smokers is 8.94 in "increase or very increase" group in diet compared to those of "no change". 6.
The multiple regression analysis has a significant model in current smoker(p=0.001). The mean BMI of those who were "very active" in exercise is higher than that of "inactive" or "active". The mean BMI of those who were "light or moderate ot heavy drinker" is lower than that of "non-drinker". The mean BMI of those who have the monthly income 1.5millions-1.99millions won is significantly higher than those having less than 1.5millions or more than 2.0millions won. The implication of this study could suggest that health education for smoking cessation needs new approches to minimize weight gain.
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An Epidemiologic Investigation of Typhoid Fever Outbreak in Pusan, 1996.
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Hai Rim Shin, Byung Seong Suh, Jue Bok Song, Duk Hee Lee, Meang Bok Lee, Jin Hyung Park, Man Su Kim, Young Hack Shin, Sang Won Lee, Hee Choul Ohrr
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Korean J Epidemiol. 1997;19(2):122-130.
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An epidemiologic investigation was carried out to identify the source of infection of typhoid fever outbreak, which was occurred in Nam-Gu, Pusan city from April 20 to June 28, 1996. The distribution of 83 reported cases (55 confirmed cases and 28 suspected cases) by sex and age group showed that this epidemic would be occurred by the exposure to a common source with low toxic pathogen because 55.4% of cases were under 20 years old and most of the adults cases were female. The epidemic curve showed a unimodel curve with a peak on about 15 May and tailed down to 23 June, suggesting that the exposure was constant. These results supposed that the contamination of a public water supply would be the source of infection. The analysis of reported cases and population survey conducted to household members and community contacts living in the epidemic area, led the conclusion that the source of infection was tap water supplied through the Dae Youn pumping station, based on the following findings: (1) There were singificant differences of incidence rate among regions (Tong) even though in the same Dong and the spot map of incident cases distributed in accord with the water supply by Dae-Youn pumping station.
(2) Among reported cases, 21 cases, including 17 confirmed cases, stated they had used only tap water. (3) The analysis of tap water from the house which had seven typhoid cases, revealed the contamination of E coli and the dilution of residual chlorinated concentration. (4) The outbreak of typhoid fever was stopped after the replacement of The worn-out pipe line of tap water supply to the new one.
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Comparisons of cholera bacilli positive and negative patients in symptoms and laboratory findings among 1991 cholera patients.
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Hee Choul Ohrr, Sun Ha Jee, Kyu Sang Kim, Yun Hwan Lee
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Korean J Epidemiol. 1996;18(2):713-181.
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Among 130 cholera patients treated in Seohae Hospital in 1991, 86 were cholera bacilli positive and remaining 44 were negative. All cholera bacilli 'positive' patients were confirmed bacteriologically by National Institute for Health team. Cholera related symptoms and laboratory findings were gathered by interviews and medical records surveys. Symptoms and some serological laboratory findings are compared between cholera bacilli 'positive' and 'negative' patients in 1991 cholera epidemic. Results are as follows: 1. There were no differences in symptoms distribution and in mean values of all serological laboratory tests done between two groups. These facts support that both cholera bacilli 'positive' and 'negative' patients are persons who have cholera bacilli infection. 2. The age distribution of the cholera bacilli 'negative' group tended to be much younger than that of 'positive' group. The infection source of this group is believed to be the environmental reservoir. This findings suggests that cholera bacilli 'negative' patients have the possibility of endemic characteristics. We think it is worth investigating Vibrio cholera antibody titers of people in area with frequent cholera epidemics in Korea.
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A Study on the Source of Cholera Epidemic of Korea 1995-1996.
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Jong Koo Lee, Sang Soon Kim, Ho Hoon Kim, Hee Choul Ohrr, Moon Sik Kim, Key Dong Park, Chang Yong Hawang
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Korean J Epidemiol. 1996;18(2):185-190.
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E1 tor cholera epidemic have been reported eight times in Korea since 1963. Researchers suspected unattempted importation of cholera bacteria from foreign countries or artificial germination by some people. No researchers have made hypotheses of environmental reservoir as the sources of cholera epidemics until in 1991 in Korea. This study focuses on the aquatic reservoir as the potential source of cholera epidemic. A total of 68 cholera patients were noted in 1995 and only two in 1996. Authors argue for aquatic reservoir as the source of 1995, 1996 cholera epidemic and designate sea fishes as the vehicle of cholera infection The national Institute of Health team cultured Vibrio cholera O1, from the samples of sea water from Kangwha county in September 1995. The sporadic Occurrence of cholera patients around the country who have not traveled out of town support aquatic environmental reservoir as the source of 1995, 1996 cholera epidemic in Korea.
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A Study on the Effect of Symptoms to Diagnosis Interval on the Cancer Survival.
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Hee Jung Kang, Hee Choul Ohrr, Hee Ok Kim, Sun Ha Jee, Tae Yong Shon
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Korean J Epidemiol. 1996;18(2):160-172.
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For many years, members of medical profession have believed that the shorter symptoms to diagnosis interval(SDI) might be related to early stages and that the prompt treatments might improve survival rates in cancer patients. But this notion has been challenged by many researches for many years. This study was conducted to investigate the effects of SDI on the cancer survival for 221 stomach cancer cases, 106 lung cancer cases, 74 liver cancer cases and 59 cervix cancer cases. These cancer cases are registered ones in Kanghwa Cancer Registery Program from 1987 to 1991.
Relationships among SDI, stages of cancers, operation rates, and survival were analysed. Results are as follows: 1. SDI was not related to stages of cancer. There were no difference in the distribution of stages among five SDI subgroups. 2. This data did not support that SDI affects the survival of stomach cancer patients. The cancer stages did affect survival in stomach cancer patients though. 3. Our data did not support that SDI affects cancer survival. A Cox proportional hazard model showed that SDI does not play a important role in cancer survival controlling age, gender, stage and other variables in the model. Further studies are highly expected to clarify the relationships between SDI and cancer survivals. Researches with bigger sample size and more sophisticated variables would be needed.
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Self Rated Health and Mortality in Elderly Kangwha Cohort, 8-year follow up.
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Hee Choul Ohrr, Sun Ha Jee, Il Soon Kim
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Korean J Epidemiol. 1994;16(2):172-180.
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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.
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A Case-control Study of Risk Factors in Stomach Cancer.
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Sang In Lee, Hee Choul Ohrr, Sun Ha Jee, Jung Sook Joo
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Korean J Epidemiol. 1994;16(2):145-154.
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Stomach cancer is the most common cancer in Korea with highest mortality. Therefore, finding risk factors involved in its prevention is vitally important. Case-control study was done to demonstrate the relationship between smoking, drinking, food, nutrition, 5% salt solution and the incidence of stomach cancer. The study group consisted of 82 patients with stomach cancers confirmed by pathology as case group and 113 patients with chronic superficial gastritis as control. General characteristics, smoking and drinking habits, dietary habit according to food groups, individual preference to salty and spicy foods were analyzed. Subjects had undergone taste test with 10cc of 0.5% salt solution.
Age adjusted odds ratios by Mantel-Haenszel test were performed for each variable. 1. Smoking in males had no direct relationship with incidence of stomach cancer, but in females there is a higher odds ratio in smoking group (OR=2.63). Drin-king had no effect on the odds ratio in males, whereas in females, the odds ratio was significantly decreased in drinking group (OR=0.25). 2. Consumption of fruits in females showed a protec-tive effect on developing stomach cancer (OR=0.41). Males who had more protein and iron intake were found to have significantly higher odds ratio for stomach cancer risk (protein OR=2.86, iron OR=5.18). 3. Salty diet habit in females showed a higher odds ratio for stomach cancer risk (OR=2.49). No correlation was found between spicy diet habit with stomach cancer. 4.
Male subjects who did not feel salty with 0.5% salt solution showed significantly increased odds ratio (OR=4.59) for stomach cancer. This study is limited due to fact that the number of subjects was not large enough for indepth evaluation and that other confounding factors other than age was not sufficiently controlled. Further investigation that concerns ingestion of fruit group, the level of subjects' taste to 0.5% salt solution, and protein and iron intake on a larger scale is recommended.
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A study on the nondifferential misclassification-a mathematical approach for correcting the estimates-.
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Chung Mo Nam, Hee Choul Ohrr
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Korean J Epidemiol. ;15(1):85-95.
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This study is conducted to suggest a method for correcting the biased estimates due to nondifferential misclassification of polytomous exposure and confounder. The basic idea for correcting the bias is a rearrangement of misclassified data structure using misclassification probability matrices. We present here a linear relationship between the misclassified and true date.
Simulation studies were also tried to investigate the magnitude and direction of the bias mentioned above. In simulation studies, we focused on the misclassification patterns in three circumstances, misclassification of exposure, misclassification of confounder, and joint misclassification of both exposure and confounding variables. The simulation results show that the direction of exposure or confounder misclassification biases are heavily dependant on the misclassification patterns.
The proposed mehod is applied to an empirical data on the presence of medical utilization and smoking history where corrected odds ratios are examplified considering plausible ranges of misclassification probaility patterns.
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