Assessing Health Impacts of Pictorial Health Warning Labels on Cigarette Packs in Korea Using DYNAMO-HIA

Kang, Eunjeong The Korean Society for Preventive Medicine 2017 Journal of Preventive Medicine and Public Health Vol.50 No.4

Objectives: This study aimed to predict the 10-year impacts of the introduction of pictorial warning labels (PWLs) on cigarette packaging in 2016 in Korea for adults using DYNAMO-HIA. Methods: In total, four scenarios were constructed to better understand the potential health impacts of PWLs: two for PWLs and the other two for a hypothetical cigarette tax increase. In both policies, an optimistic and a conservative scenario were constructed. The reference scenario assumed the 2015 smoking rate would remain the same. Demographic data and epidemiological data were obtained from various sources. Differences in the predicted smoking prevalence and prevalence, incidence, and mortality from diseases were compared between the reference scenario and the four policy scenarios. Results: It was predicted that the optimistic PWLs scenario (PWO) would lower the smoking rate by 4.79% in males and 0.66% in females compared to the reference scenario in 2017. However, the impact on the reduction of the smoking rate was expected to diminish over time. PWO will prevent 85 238 cases of diabetes, 67 948 of chronic obstructive pulmonary disease, 31 526 of ischemic heart disease, 21 036 of lung cancer, and 3972 prevalent cases of oral cancer in total over the 10-year span due to the reductions in smoking prevalence. The impacts of PWO are expected to be between the impact of the optimistic and the conservative cigarette tax increase scenarios. The results were sensitive to the transition probability of smoking status. Conclusions: The introduction of PWLs in 2016 in Korea is expected reduce smoking prevalence and disease cases for the next 10 years, but regular replacements of PWLs are needed for persistent impacts.

Metabolic risks in living kidney donors in South Korea

( Eunjeong Kang ),( Jina Park ),( Hyo Jeong Kim ),( Sehoon Park ),( Minsu Park ),( Yaerim Kim ),( Kwangsoo Kim ),( Sang Min Park ),( Dong-Wan Chae ),( Ho Jun Chin ),( Jung Pyo Lee ),( Sik Lee ),( Soo 대한신장학회 2021 Kidney Research and Clinical Practice Vol.40 No.4

Background: Considering the growing prevalence of Western lifestyles and related chronic diseases occurring in South Korea, this study aimed to explore the progression of metabolic risk factors in living kidney donors. Methods: This study enrolled living kidney donors from seven hospitals from 1982 to 2016. The controls were individuals that voluntarily received health check-ups from 1995 to 2016 that were matched with donors according to age, sex, diabetes status, baseline estimated glomerular filtration rate, and date of the medical record. Data on hyperuricemia, hypertension, hypercholesterolemia, and overweight/obesity were collected to determine metabolic risks. Logistic regressions with interaction terms between the medical record date and donor status were used to compare the trends in metabolic risks over time in the two groups. Results: A total of 2,018 living kidney donors and matched non-donors were included. The median age was 44.0 years and 54.0% were women. The living kidney donors showed a lower absolute prevalence for all metabolic risk factors, except for those that were overweight/obese, than the non-donors. The proportion of subjects that were overweight/obese was consistently higher over time in the donor group. The changes over time in the prevalence of each metabolic risk were not significantly different between groups, except for a lower prevalence of metabolic risk factors ≥ 3 in donors. Conclusion: Over time, metabolic risks in living kidney donors are generally the same as in non-donors, except for a lower prevalence of metabolic risk factors ≥3 in donors.

쇼그렌 증후군에 동반된 원위신세관산증 2예

( Eunjeong Kang ),( Seokwoo Park ),( Sehoon Park ),( Hajeong Lee ),( Kwon Wook Joo ),( Jin Suk Han ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Renal tubular acidosis (RTA) is a syndrome characterized by hyperchloremic metabolic acidosis and an inability to excrete a highly acid urine, in which impairment of acid excretion is out of proportion to reduction of glomerular filtration rate. Distal renal tubular acidosis (dRTA) is frequently associated with immune-mediated disease including Sjigren’s syndrome. Sjigren’s syndrome is a systemic autoimmune disease that mainly affects the exocrine glands such as lacrimal and salivary glands, resulting in xerophtalmia and xerostomia. Extrglandular manifestations are frequent and may include renal involvement. Recently, we experienced two cases of renal tubular acidosis in Sjigren’s syndrome. The 1st case was a patient who had lower extremities weakness and hypokalemia, and the 2nd case was a patient who had nephrocalcinosis. We discussed the frequencies and the pathogenesis of dRTA in Sjigren’s syndrome. Keywords: Sjigren’s syndrome; Distal renal tubular acidosis; Hypokalemia; Nephrocalcinosis

Baseline General Characteristics of the Korean Chronic Kidney Disease: Report from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD)

Kang, Eunjeong,Han, Miyeun,Kim, Hyunsuk,Park, Sue Kyung,Lee, Joongyub,Hyun, Young Youl,Kim, Yong-Soo,Chung, Wookyung,Kim, Hyo Jin,Oh, Yun Kyu,Ahn, Curie,Oh, Kook-Hwan The Korean Academy of Medical Sciences 2017 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.32 No.2

<P>The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was developed to investigate various clinical courses and risk factors for progression of Korean chronic kidney disease (CKD). The KNOW-CKD study consists of nine clinical centers in Korea, and patients aged between 20 and 75 years with CKD from stage 1 to 5 (predialysis) were recruited. At baseline, blood and urine samples were obtained and demographic data including comorbidities, drugs, quality of life, and health behaviors were collected. Estimated glomerular filtration rate (eGFR) was calculated by 4-variable Modification of Diet in Renal Disease (MDRD) equation using isotope dilution mass spectrometry (IDMS)-calibrated serum creatinine measured at a central laboratory.</P><P>As a dynamic cohort, a total of 2,341 patients were enrolled during the enrollment period from 2011 until 2015, among whom 2,238 subjects were finally analyzed for baseline profiles. The mean age of the cohort was 53.7 ± 12.2 year and 61.2% were men. Mean eGFR was 50.5 ± 30.3 mL/min/1.73 m<SUP>2</SUP>. The participants with lower eGFR had a tendency to be older, with more comorbidities, to have higher systolic blood pressure (BP) and pulse pressure, with lower income level and education attainment. The patients categorized as glomerulonephritis (GN) were 36.2% followed by diabetic nephropathy (DN, 23.2%), hypertensive nephropathy (HTN, 18.3%), polycystic kidney disease (PKD, 16.3%), and other unclassified disease (6.1%). The KNOW-CKD participants will be longitudinally followed for 10 years. The study will provide better understanding for physicians regarding clinical outcomes, especially renal and cardiovascular outcomes in CKD patients.</P>

Sex-specific Relationship of Serum Uric Acid with All-cause Mortality in Adults with Normal Kidney Function: An Observational Study

Kang, Eunjeong,Hwang, Seung-sik,Kim, Dong Ki,Oh, Kook-Hwan,Joo, Kwon Wook,Kim, Yon Su,Lee, Hajeong The Journal of Rheumatology 2017 The Journal of rheumatology Vol.44 No.3

<B>Objective.</B><P>To explain the clinical effect of serum uric acid (SUA) levels as a risk factor for mortality, considering exclusion of kidney function.</P><B>Methods.</B><P>Participants aged over 40 years who underwent health checkups were recruited. Individuals with estimated glomerular filtrations rates < 60 ml/min/1.73 m<SUP>2</SUP> and who received laboratory study and colonoscopy on the same day were excluded.</P><B>Results.</B><P>SUA levels were higher in men than in women (5.7 ± 1.2 mg/dl for men and 4.2 ± 0.9 mg/dl for women, p < 0.001). During 12.3 ± 3.6 years of followup, 1402 deaths occurred among 27,490 participants. About 6.9% of men and 3.1% of women died. The overall mortality rate had a U-shaped association with SUA levels, a U-shaped association in men, and no association in women. There was a significant interaction of sex for the SUA-mortality association (p for interaction = 0.049); therefore, survival analysis was conducted by sex. In men, the lower SUA group had a higher mortality rate after adjustment (SUA ≤ 4.0 mg/dl, adjusted HR 1.413, 95% CI 1.158-1.724, p = 0.001) compared with the reference group (SUA 4.1-6.0 mg/dl). A higher SUA contributed to an insignificant increased mortality in men (> 8.0 mg/dl, adjusted HR 1.140, 95% CI 0.794-1.636, p = 0.479). Women failed to show any significant association between SUA and mortality.</P><B>Conclusion.</B><P>This study provided novel evidence that SUA-mortality association differed by sex. We demonstrated that a lower SUA was an independent risk factor for all-cause mortality in men with normal kidney function.</P>

건강도시지수를 위한 건강도시지표의 타당성과 자료생산 가능성

강은정 ( Eunjeong Kang ),고광옥 ( Kwang Wook Koh ),김건엽 ( Keon Yeop Kim ),김은정 ( Eun Jung Kim ),김복미 ( Bok Mi Kim ) 대한보건협회 2017 대한보건연구 Vol.43 No.2

연구목적 : 본 연구의 목적은 건강도시지수 개발을 위해 필요한 건강도시지표를 개발하고 그들의 타당성과 자료가용성을 확인하는 것이다. 연구방법 : 문헌고찰을 통해 기존의 국내 및 국외의 건강도시지표들을 수집하였다. 총 72개의 지표들을 11개 영역으로 구분하였다. 2016년 9월 19일부터 10월 7일까지 16명의 건강도시 실무자 및 전문가를 대상으로 이메일을 통한 자가기입식 설문조사를 실시하였다. 조사를 통해 각 지표의 정책관련성, 액면타당성, 내용타당성, 그리고 자료가용성을 5점 척도로 평가하였다. 연구결과 : 정책관련성, 액면타당성, 내용타당성, 자료가용성에 대한 모든 72개 지표들의 평균점수는 각각 3.96, 3.87, 3.84, 3.88이었다. 몇 개를 제외한 모든 지표들의 평균이 3점을 넘었다. 네 가지 평가기준 모두에서 구조와 과정 지표들과 함께 결과 영역 중 건강행태 및 건강결과 지표들이 물리적, 사회적, 경제적 환경 및 보건의료자원 및 서비스 지표들보다 더 높은 점수를 얻었다. 결론 : 건강도시지수를 위해 개발된 건강도시지표들은 타당하고 자료가용성이 만족스러운 것으로 나타났다. Objective: The purpose of the study was to develop a comprehensive set of Healthy City indicators to be used to develop a Healthy City index and to examine their validity and data availability. Methods: Previous domestic and international Healthy City indicators were collected from literature review. Seventy two indicators categorized in 11 domains were finally selected. A self-administered survey was conducted between September, 19 and October 7 in 2016 via e-mail among 16 experts or practitioners in Healthy City. They rated policy relevance, face validity, content validity, and data availability of each indicator based on its pre-described definition on the 5 Likert scale. Results: The average scores for policy relevance, face validity, content validity, and data availability across 72 indicators were 3.96, 3.87, 3.84, 3.88, respectively. All the indicators were rated over 3 on average except a few indicators. In all the four evaluation criteria, structure and process indicators as well as the indicators for health behavior and health outcome were rated higher than those indicators for physical, social, and economic environments and healthcare resources and services. Conclusion: The Healthy City indicators developed for a Healthy City index were found to be valid and their data availability were satisfactory.

인공지능 스피커를 활용한 정보 검색이 온라인 구매 경험에 미치는 영향

강은정(EunJeong Kang),최용순(Yongsoon Choi) 한국HCI학회 2019 한국HCI학회 학술대회 Vol.2019 No.2

본 연구에서는 광고 마케팅 분야에서 인공지능 스피커의 활용 가능성을 탐구하기 위한 기반 연구로 인공지능 스피커 사용 과정에 소비자 구매 행동 모델인 AISAS 모델을 접목해보고자 하였다. 특히, 인공지능 스피커의 ‘검색’ 기능을 활용하여, 소비자가 제품 탐색과정에서 인공지능 스피커를 사용하였을 경우 쇼핑서비스의 신뢰도와 사용성을 알아보고자 실험을 진행하였다. 그 결과, 인공지능 스피커의 검색 활동보조 역할이 소비자의 제품 탐색 활동에 영향을 준 것으로 나타났다. 현재 인공지능 스피커를 활용한 광고마케팅 시장은 초기 진입 상태로 효과적인 Use Case 가 부족한 상황에서, 본 실험은 향후 인공지능 스피커를 광고 마케팅의 미디어로써 사용해야 할 기업들에게 중요한 방향성을 제시할 것으로 기대한다.

Evolving outcomes of peritoneal dialysis: secular trends at a single large center over three decades

( Minjung Kang ),( Yae Lim Kim ),( Eunjeong Kang ),( Hyunjin Ryu ),( Yong Chul Kim ),( Dong Ki Kim ),( Hajeong Lee ),( Seung Seok Han ),( Kwon-wook Joo ),( Yon Su Kim ),( Curie Ahn ),( Kook-hwan Oh ) 대한신장학회 2021 Kidney Research and Clinical Practice Vol.40 No.3

Background: Peritoneal dialysis (PD) is improving as a renal replacement therapy for end-stage renal disease (ESRD) patients. We analyzed the main outcomes of PD over the last three decades at a single large-scale PD center with an established high-quality care system. Methods: As a retrospective cohort study, we included participants (n = 1,203) who began PD between 1990 and 2019. Major PD-related outcomes were compared among the three 10-year cohorts. esults: The 1,203 participants were 58.3% male with a mean age of 47.9 ± 13.8 years. The median PD treatment duration was 45 months (interquartile range, 19-77 months); 362 patients (30.1%) transferred to hemodialysis, 289 (24.0%) received kidney trans-plants, and 224 (18.6%) died. Overall, the 5- and 8-year adjust patient survival rates were 64% and 49%, respectively. Common caus-es of death included infection (n = 55), cardiac (n = 38), and cerebrovascular (n = 17) events. The 5- and 8-year technique survival rates were 77% and 62%, respectively, with common causes of technique failure being infection (42.3%) and solute/water clearance problems (22.7%). The 5-year patient survival significantly improved over time (64% for the 1990-1999 cohort vs. 93% for the 2010-2019 cohort). The peritonitis rate also substantially decreased over time, from 0.278 episodes/patient-year (2000-2004) to 0.162 episodes/patient-year (2015-2019). Conclusion: PD is an effective treatment option for ESRD patients. There was a substantial improvement in the patient survival and peritonitis rates over time. Establishing adequate infrastructure and an effective system for high-quality PD therapy may be warranted to improve PD outcomes.

도시건강 연구에서 도시건강학회의 역할

강은정(Eunjeong Kang) 도시건강학회 2022 도시건강연구 Vol.1 No.1

Urban is an important determinant of health and health is analyzed and problems are solved through lens of urban in urban health. Since various stakeholders from multi-levels and multi-sectors are involved, urban health is intrinsically complex. In order to deal with the complexity of urban health, systems approach is needed. Urban health emerged with the efforts of improving the miserable situation of the urban poor in the late 19th century, which, however, was suppressed by biomedical model of health. As urbanization began in mid 20th century, various international agencies, philanthropic institutes, and academic societies came into play in urban health. Climate change and COVID-19 pandemic have greatly impacted urban health. Although the importance of urban health is well-noticed, urban health research has not gained much political supports and we discussed six reasons why. Finally, we suggested the role of Academy of Urban Health in urban health research in 3 ways. First, the Academy should be a venue of intellectual collaboration among scholars of different expertise and backgrounds. Second, priority research agenda in urban health need to be addressed. Third, urban health education needs to be developed.

증례 : 신장 ; 쇼그렌증후군에 동반된 원위신세관산증 2예

강은정 ( Eunjeong Kang ),박석우 ( Seokwoo Park ),박세훈 ( Sehoon Park ),이하정 ( Hajeong Lee ),이은영 ( Eun Young Lee ),한진석 ( Jin Suk Han ),주권욱 ( Kwon Wook Joo ) 대한내과학회 2016 대한내과학회지 Vol.90 No.3

저자들은 저칼륨혈증 및 신석회증을 각각 주 증상으로 발현된 쇼그렌증후군 동반 원위신세관산증 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Renal tubular acidosis (RTA) is a syndrome characterized by hyperchloremic metabolic acidosis and an inability to excrete highly acid urine, in which the impaired acid excretion is disproportional to the reduction in the glomerular filtration rate. Distal renal tubular acidosis (dRTA) is frequently associated with immune-mediated disease, including Sjogren’s syndrome. Sjogren’s syndrome is a systemic autoimmune disease that mainly affects exocrine glands, such as the lacrimal and salivary glands, resulting in xerophthalmia and xerostomia. Extraglandular manifestations are frequent and may include renal involvement. Recently, we experienced two cases of renal tubular acidosis in patients with Sjogren’s syndrome. The first patient had lower extremity weakness and hypokalemia and the second had nephrocalcinosis. We discuss the frequency and pathogenesis of dRTA in Sjogren’s syndrome. (Korean J Med 2016;90:248-252)