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Volume 24 (2); December 2002
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Reviews
Food, Nutrient, and the Risk of Breast Cancer.
Myung Hee Shin
Korean J Epidemiol. 2002;24(2):164-170.
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Abstract
Nutrients are the primary dietary component that are of interest in studying the diet-disease relationships because they give us more direct biological mechanisms. However, exploring the associations of the foods or food groups with disease occurrence could also give us an important information in the causal relationships between diet and diseases. When there are no specific nutrient that was shown to be related to a disease, a relationship between a certain food and the disease could provide a new hypothesis for the responsible components. If an association exists with both the overall intake of a nutrient and more than one food source of that nutrient, it is more likely that the association is causal. On the other hand, foods with similar nutrient components could have different effects on our body due to a complex interaction between the nutrients within the food. Epidemiologists should employ both approach (nutrient and food) in order to have an unbiased assessment for the association between diet and diseases. We will take an example of a cohort study which looked at the association between dairy products, calcium, and vitamin D and the risk of breast cancer.
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The Effects of Psychosocial Factors in the Stress Process.
Sei Jin Chang
Korean J Epidemiol. 2002;24(2):148-163.
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Abstract
For the past three decades, considerable attentions have been paid to the search for stressors, stress outcomes and stress modifiers that may reduce the impact of exposure to environmental stressors. Especially medical sociologists and psychologists in medical parts, had an intellectual contribution to the development of stress research. They have presented an excellent opportunity to examine how deeply well-being is affected by the socially structured arrangements of people's lives and by the continuous experiences that result from these arrangements. The predominant concern has been with the role of coping resources, especially social support, coping and so on. The majority of studies report modest but significant positive association between life event levels and physical and mental symtomatology. In particular, the importance of considering psychosocial factors that may modify the effects of stressors on the risk factors for diseases or onset of illness has been emphasized increasingly. Clearly, stress is a complex process in which social, psychological and physiological environments simultaneously affect well-being. This study was performed to document the effect of psychosocial factors such social support, coping, personality traits which had been well known as stress modifiers in the stress process.
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Relationship between Stress and Biomarkers.
Sang Baek Koh
Korean J Epidemiol. 2002;24(2):137-147.
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Abstract
Stress can induce modifications in the central nervous(CNS), autonomic nervous and neuroendocrine system. Thus, the stress response has long been measured in laboratory experiments by biochemical changes in the hormone systems that are referred to as the sympathetic nervous system(SNS) and pituitary-adrenocortical axes(HPA). These axes react to acute stress or chronic stress. The activation of these two particular pathways result in elevated serum levels of catecholamines, cortisol, ACTH, dopamine, and others hormones. But there is considerable debate about the relevance of traditional laboratory stress findings to real-life situation. The neurobiology of stress is a key step to the understanding of stress-induced changes of immune functions. The immune system operates in communication with brain and endocrine system. Because of this extensive communication, the immune system can influence how we feel and behave. The stress are associated with endocrine and autonomic changes that can inhibit immune system function. The concept of neurocardiology renders plausible the various theoretical constructs of stress as they relate to circulatory vascular disease. Detailed reviews of the anatomic connections between the brain and the heart and of experimental and clinical data on the role of the CNS in cardiac dysfunction can be found elsewhere. In this study, we reviewed that stress was associated with cardiovascular disease mortality through the known cardiovascular risk factors(hypertension, heart rate variability, homocycteine, and clotting system).
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Stress and Cardiovascular Disease.
Byung Yeol Chun
Korean J Epidemiol. 2002;24(2):131-136.
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Abstract
Stress is a newly recognized risk factor that appears to contribute to all recognized mechanisms underlying cardiac events, specifically, by clustering of traditional cardiovascular risk factors, endothelial dysfunction, myocardial ischemia, plaque rupture, thrombosis, and malignant arrhythmia. And it is necessary to study on the role of stress in the causation of developing cardiovascular disease by a direct hormonal effect on heart or an indirect behavioral change. A better understanding of the behavioral and physiologic associations between psychological stress and cardiovascular disease will assist researchers in developing effective approaches for reducing or reversing the damaging effects of stress and may lead to further reductions of CVD morbidity and mortality in Korea.
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Original Articles
Lung cancer incidence, mortality and survival rate in Korean Elderly Pharmacoepidemiologic Cohort(KEPEC) in 1994-1998.
Nam Kyong Choi, Kyung Eun Youn, Dae Seuk Heo, Yooni Kim, Seung Mi Lee, Byung Joo Park
Korean J Epidemiol. 2002;24(2):121-130.
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Abstract
PURPOSE
This study was conducted to estimate incidence, mortality and survival rate of lung cancer in the elderly people in Korea.
METHODS
Study population was Korean Elderly Phamacoepidemiologic Cohort (KEPEC). The lung cancer incidence cases were detected from three different sources, medical utilization database of the Korea Medical Insurance Corporation (KMIC), the database from the National Cancer Registry, and the database from the Regional Cancer Registry. The hospital survey to confirm the final diagnosis of the potential cases was conducted. A specialist on lung cancer reviewed the abstracted data to confirm the final diagnoses. The lung cancer death cases were detected from the mortality database at National Statistical Office. Incidence rate, survival rate and mortality rate of lung cancer and their 95% confidence intervals were estimated with SAS Window ver. 8.1. PESULTS: There were 213 confirmed lung cancer cases in KEPEC between Jan. 1994 and Dec. 1998. Age-standardized incidence rate of lung cancer to the Korean population was estimated to be 316.9 per 100,000 person-years in male and 65.2 per 100,000 person-years in female. Age-standardized mortality rate of lung cancer to the Korean population was estimated to be 342.3 per 100,000 person-years in male and 84.8 per 100,000 person-years in female. One year survival rate was 17% in male and 11% in female. Two year survival rate was 2% in male and 4% in female.
CONCLUSION
Age-standardized incidence rate, age-standardized mortality rate and survival rate of lung cancer in the elderly Korean may be useful for further study and making health policy for managing lung cancer in the elderly.
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Bone Mineral Density and Related Factors of Postmenopausal Women.
Jae Hee Son, Byung Yeol Chun, Min Hae Yeh, Kyung Eun Lee, Sam Soon Lee, Young Seok Lee, Bong Gie Kim
Korean J Epidemiol. 2002;24(2):113-120.
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Abstract
PURPOSE
This study was conducted to estimate the prevalence of osteoporosis and to identify the related factors of bone mineral density (BMD) in rural postmenopausal women.
METHODS
Three hundred ninety postmenopausal women in a rural area were examined in 1999 Their BMDs of the lumbar spine (L1-L3) were measured by a quantitative computerized tomography (QCT) and their height and weight were measured. A questionnaires interviewing method was used to collect risk factor data. PESULTS: The prevalence of osteoporosis in postmenopausal women of 40-69 years old was 89.2% by reference value of UCSF(University of California, Sanfrancisco), however, changed to 63.1% by that of Korean. From simple analyses, age(p<0.01), duration after menopause (p<0.01), menstrual regularity(p<0.05), delivery frequencies (p<0.01), breast feeding years (p<0.01), alcohol intake(p<0.01), and smoking(p<0.05) were significant risk factors relating to BMD. In multiple linear regression analysis, duration after menopause(p<0.01), menstrual regularity(p<0.05), and breast feeding years (p<0.05) proved to be significant risk factors. However dietary factors and life style were not significantly associated with BMD.
CONCLUSIONS
The significant risk factors of postmenopausal women in a rural area relating to BMD were duration after menopause, menstrual regularity, and breast feeding duration.
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Sero-prevalence of Hepatitis B Virus Surface Antigen and Antibody in High School Students in Chungju-city.
Hyeongsu Kim, Kun Sei Lee, Soung Hoon Chang, Suekyung Park, Cheongsik Kim, Chang Hee Lee, Hyuk Jung Kweon, Soon Sup Chung
Korean J Epidemiol. 2002;24(2):107-112.
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Abstract
OBJECTIVES
Since Korea has been known to be one of the endemic area for hepatitis B virus(HBV) infection, vaccination for HBV has been recommended for all neonates in Korea. After starting vaccination in 1983, the change of sero-positivity of HBsAg and HBsAb is expected. This study was carried out to investigate the seropositive rate of hepatitis B virus surface antigen and antibody in high school freshmen students in Chungju-city.
METHODS
AND MATERIALS: From 1998 to 2001, a total of 11,735 who were born in 1982 to 1986, were enrolled in this study. HBsAg and anti-HBs were tested by reversed passive hemagglutination and passive hemagglutination, respectively. PESULTS: The study population was 11,735 students who were composed of 5,813 males (49.6%) and 5,914 females (50.4%). The HBsAg sero-positivity of male and female students was 3.25% (n=381) and 2.59% (n=153) respectively. The anti-HBs sero-positivity of male and female students was 62.2% (n=3,154) and 64.1% (n=2,969) respectively. There are significant difference observed in comparison of HBsAg and anti-HBs seropositivity according to sex (p<0.05). From 1982 to 1986 on birth year, anti-HBs sero-positivity has been increased significantly from 63.3% to 73.3%. But the change of HBsAg sero-positivity has not been changed significantly.
CONCLUSIONS
As compared with previous studies of HBsAg and anti-HBs, the sero-positive rate of HBsAg has not been changed but that of HBsAb has been increased significantly. This result revealed that the effect of HBV vaccination program was successful.
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Meta-Analysis
The Association between Helicobacter pylori Infection and Gastric Adenocarcinoma: a Review of the Literature.
So Young Oh, Aesun Shin, Seung Sik Hwang, Keun Young Yoo
Korean J Epidemiol. 2002;24(2):93-106.
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Abstract
PURPOSE
Stomach cancer is a major cancer in the world as well as in Korea. Helicobacter pylori infection was suggested causing atropic gastritis, but there has been a debate on the association with the gastric adenocarcinoma. We reviewed recent literatures and meta-analyses on the association between Helicobacter pylori infection and the development of gastric adenocarcinoma. PESULTS: The animal experiments suggested that Helicobacter pylori is a causative agent of gastric adenocarcinoma. Meta-analyses on the relationship between Helicobacter pylori infection and gastric adenocarcinoma showed increased risk in infected person, but the strength of association was varied with study design, characteristics of study participants and the nature of tumors.
CONCLUSIONS
Recent study results suggested that Helicobacter pylori is a necessary causative agent for development of gastric adenocarcinoma. Assessment of the association between Helicobacter pylori infection and other factors related with gastric cancer risks and the effects of the eradication therapy of Helicobacter pylori infection on the prevention of gastvic cancer need further evaluation.
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Epidemiol Health : Epidemiology and Health